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Book {J o X/__. 

Copyright^ _ 

COPYRIGHT DEPOSIT. 



The Working People 

Their Health and How 
to Protect It 



By M. G. Overlook, M.D. 

Member of the Advisory Committee, American Health League 

Committee of One Hundred on National Health 

Charter Member of the National Association for the Prevention 

of Tuberculosis 

Member of the American Medical Association 

Member of the Massachusetts Medical Association 

Author of the Bill to Allow Cities and Towns in Massachusetts 

to Care for Advanced Cases of Tuberculosis 

Originator of the Movement whereby Manufacturers and 

Merchants Care for their Cases of 

Incipient Tuberculosis 

Trustee of the Worcester City Hospital 

Formerly Vice-Chairman of the Board of Education, Worcester 

President of the Worcester Social Settlement Association 

Chairman of the Executive Committee of the Worcester 

Consumptives' Home Association 

Member of the National Association for the 

Advancement of Science 



MASSACHUSETTS HEALTH BOOK 

PUBLISHING COMPANY 

BOSTON 



A 



#v 



Copyrighted iqii by 
MELVIN G. OVERLOCK 

Worcester, Mass. 



€ Cl A 280992 



TO 
THE MEMORY OF MY PRECEPTOR 

J. Bartlett Rich, M.D. 

WHO FOR NEARLY TWENTY-FIVE YEARS SUSTAINED 

THE HIGH IDEAS 

OF THE GENERAL PRACTITIONER 



TABLE OF CONTENTS. 

Chapter. Page. 

I. What Prevents an Absolutely Healthy Person 

from Contracting Consumption, 13 

II. Importance of Early Recognition of Consumption 

Among the Working Classes, 16 

III. Going West for One's Health, 19 

IV. The Warfare against Tuberculosis not a Hope- 

less Struggle, 23 

V. Patent Medicines and their Effects, 31 

VI. The Home as a Sanitarium, 34 

VII. Consumption Among School Children — its 

Cause and Prevention, 37 

VIII. The Importance of Early Attention to Ca- 

tarrh in Children, 50 

IX. Are We All Tubercular? 53 

X. After the Sanitarium or Preliminary Rest-cure 

at Home, What Next? 56 

XI. Prevention of the Spread of Tuberculosis, 67 

XII. Dangers of Overwork, 82 

XIII. Walking and its Relation to Health, 86 

XIV. Prevention of Disease Among Those who Fol- 

low Different Occupations, 89 

XV. How to Live a Hundred Years, 96 

XVI. Conservation of the Nation's Health, 103 

XVII. The Working Day, 106 

XVIII. Hygiene, 109 

XIX. Should the Pregnant Woman Work in Fac- 

tories? 139 

XX. The Working People as Spendthrifts, and Why ? 141 

XXI. School Buildings and the Prevention of Dis- 

ease, 146 

XXII. Rest in the Prevention of Tuberculosis, 148 

XXIII. Drinking-cups and their Relation to Disease, 153 

XXIV. Flies and their Menace to Health, 163 

XXV. The Modern Factory and what it Means to 
the People Employed Therein, 166 



TABLE OF CONTENTS. 7 

Chapter. Page. 

XXVI. Appendicitis, 169 

XXVII. Dyspepsia, and How to Avoid it, 172 

XXVIII. Dangers of City Life, 175 

XXIX. Rheumatism, its Cause and Prevention, 180 

XXX. The Open-air School and its Wisdom, 182 

XXXI. Spitting and its Dangers, 186 

XXXII. Nervousness, its Causes and its Prevention, 189 

XXXIII. Diphtheria — What Causes it? What Pre- 
vents it? 192 

XXXIV. Care of the Child from Birth until the 
Fourteenth Year, 196 

XXXV. Scarlet Fever a Dangerous Disease, and How 

to Prevent it, 210 

XXXVI. Breathing Exercises and their Value to 
Health, 214 

XXXVII. Worry and its Effect upon the Health, 219 

XXXVIII. Heart Disease, its Cause and Prevention, 223 

XXXIX. How to Cook for the Sick, 226 
XL. Family Medicine Chest, 233 
XLI. Protection of Health, 237 
XLII. Typhoid Fever — its Early Symptoms, and how 

it Can be Avoided, 255 

XLIII. For the Young Man, Shall it be the Factory 

or the Farm? 258 

XLIV. Measles a Dangerous Disease, and Why? 260 

XLV. The Young Man, the Cigarette and the 

Saloon, 262 

XLVI. Municipal Sanitariums and How they Can 

be Established, 264 

XLVII. Emergencies, and What to Do When they 

Arise, 266 

XLVIII. Dancing and its Relation to Pneumonia 

and Consumption, 270 

XLIX. What to Eat and How to Eat it, 272 

L. Hydrotherapy and its Relation to Health, 277 

LI. The Press and its Influence in the Fight 

Against Consumption, 286 

LI I. Conclusions, 291 

LIII. Acknowledgments, 293 



PREFACE 

BECAUSE of the cordial reception accorded the 
first edition of "The Working People, Their 
Health and How to Protect It," by the medical 
fraternity and laity, this second edition of ten thou- 
sand copies has been rendered imperative. 

M. G. Overlook, M.D. 



INTRODUCTION 

THIS is a plain book written in a plain way by a 
plain man for plain people. By this we do not 
necessarily adopt the politician's definition of the 
plain people. We refer to that great mass of men and 
women who make up the bone and sinew of this 
nation — the toilers — whose health is their prin- 
cipal asset, and who, when they are stricken down 
by disease, see ahead of them nothing but a long, 
straight road that leads directly through the poor- 
house into an open grave. 

The rich can afford to be sick. It is merely an 
incident in their well-sheltered lives. Their income 
does not diminish when they fall sick. Indeed, 
through a fortunate rise in stocks, it may actually 
be greater when they are sick than when they are 
well. With the poor man — not the pauper, but the 
great middle class workman, dependent on his labor 
for his daily bread — the situation is far different. 
The instant he falls sick his income stops, and if he 
has a family dependent upon him, God help him — 
and them. It is, therefore, absolutely necessary that 
the working people of this country, men and women 
alike, should preserve their health as if it were so 
much gold. The rich man stores his capital in great 
steel vaults in massive banks surrounded by every 
safeguard that human ingenuity can suggest. The 
poor man's health is his capital, and he squanders 



INTRODUCTION 

it as if it were the leaves upon the trees and he were 
the owner of vast forests. 

We have devoted much space in this volume to 
tuberculosis — consumption, as it is popularly known 
— but we have not lost sight of other diseases to which 
the American workman is particularly susceptible. 

We have endeavored to clothe what we had to 
say in language that a child could understand, and 
we can assert freely that if every reader of this book 
will follow our advice, he will add many, many years 
to his life. 

We have heard a good deal in this country in the 
last five years of the Osier theory. The best refu- 
tation that we know of the Osier theory is Dr. Osier 
himself. At sixty years of age he is one of the most 
efficient, luminous minded and irreplaceable men on 
the globe. He is more efficient than he was at fifty; 
he is far more efficient than he was at forty. 

Horace Greeley once declared: "They say to you 
a man's a man when he's twenty-one. I say to you 
a man isn't a man until he's thirty-eight." If any 
man or woman confronting middle life is reading 
these words, I want to say to you that your best 
years are just before you. At forty you should look 
forward to thirty years of increasingly active useful- 
ness. The great compelling force that has molded 
your whole life has been the knowledge that you 
will be poor if you do not exert yourself. From this 
time forth your great concern should be, not to accu- 
mulate riches, but to accumulate health, for health, 
if you are poor, is your capital. 

I have endeavored in this book to show you how 
to keep your capital — health — unimpaired, and if it 
is impaired how to regain it, for it is still as true as 



INTRODUCTION 

when it was originally written that "it is said the 
greatest thing in the world is to be healthy," but I 
say no, it is a far greater thing to become healthy. 

Finally, to the sick and to the well, to the rich 
and the poor everywhere, I want to preach the doc- 
trine of courage. I have endeavored to outline in 
this book some of the modern methods that are 
being undertaken to combat tuberculosis and to 
extend the sway of preventive medicine, and I want 
to say to every reader of this book that we are stand- 
ing today at the very dawn of a new era of human- 
itarianism. Every effort that science and wealth 
can put forth to enable man to live on a higher plane, 
and to live on that plane longer, is being done. Old 
age is being pushed farther and farther into the 
background. Man's wage-earning utility at fifty, 
sixty, and seventy years of age is not a dream or a 
possibility, but is practically an accomplished fact. 
Inside of twenty-five years our civilization with its 
constantly ameliorating conditions for the laborer 
will have conquered tuberculosis and every other 
disease which is the product of over-work, impure air, 
lack of nourishment, and our great American curse 
— worry for fear of dying poor. 

If what I have written, after years of practical 
experience in labor and industrial problems and 
after coming to hand-grips with the great white 
plague itself, shall help some soul out of the dark- 
ness of disease and despair into the sunlight of health 
and happiness, then the prime object for which this 
work was undertaken will have been accomplished. 

Melvin G. Overlook, M.D. 

Worcester, Mass., May 2, 1909. 



CHAPTER I 

What Prevents an Absolutely Healthy Person 
from Contracting Consumption 

Col. Robert G. Ingersoll used to say if he had 
created humanity, he would have made health 
catching rather than disease. If you will follow my 
advice in these pages you will not have to catch 
health — it will stay right with you. 

Take consumption, for example; we now know 
that it is caused by a small germ called the bacillus, 
a word taken from the Greek and so called because 
under the microscope it has the appearance of the 
walking-stick. These germs are everywhere pres- 
ent in varying quantities, but they love darkness, 
dampness and foul air. If your occupation compels 
you to put up with any or all of these three menaces 
to health, your obligation to keep the factor of 
safety — your bodily health — at the highest point is 
imperative. 

You must eat wholesome, nourishing food, sleep 
with your windows open, brush your teeth before 
and after each meal and on rising and retiring. If 
you would avoid consumption you must keep the 
tubercle germs out of your system. But should 
they gain lodgment do not despair. Man is so 
fearfully and wonderfully made that the blood 



14 THE WORKING PEOPLE: THEIR HEALTH 

itself fights with ferocious energy to expel the 
invader. The white corpuscles of the blood are 
literally warriors standing at the very gateway of 
the system to repel and expel disease of all types. 
But you must help the white corpuscle fight his 
battle if he is to win. You cannot starve him with 
poor food, you must not stifle him with impure air, 
you cannot suffocate him with the poisons of a 
germ-laden mouth and unclean teeth. 

It is unnecessary for me perhaps to say to you 
that spitting is one of the most potent causes of the 
spread of tuberculosis. If a case of advanced con- 
sumption is taken care of in the proper manner, 
that means that the sputum and the feces and the 
urine should be destroyed or burned, that a spit- 
cup be always used, and that if it is in the country 
the proper amount of disinfectants should be placed 
in the stools, and here again chloride of lime is one 
of the cheapest and best. If the room in which the 
patient is confined receives plenty of light and air, 
and if proper attention is paid to the general clean- 
liness surrounding the patient, he need not be 
feared as a source of infection. People to-day have 
heard so much about tuberculosis and how it can be 
communicated from one person to another, they 
have begun to have a sort of insane fear of the 
patient suffering from consumption. A number of 
cases have come to my notice during the last 
two or three years where a patient has been de- 
serted by all his former associates, because they 
were afraid they were going to contract consump- 
tion if they made him a visit or went near him. 
This fear is unfounded and nonsensical. 



AND HOW TO PROTECT IT. 15 

In the old Brompton Hospital in London, Eng- 
land, the oldest of its kind in the world for the care 
of tuberculosis, the hospital records show that with- 
in the last ninety years only two nurses have con- 
tracted tuberculosis in the institution, although it 
cares mainly for advanced cases. This means that 
the utmost care was exercised in the avoidance of 
those things I have already mentioned. 

Therefore, in conclusion, I again say that con- 
sumption is a disease of filth, carelessness, willful 
neglect and intemperance, all of them factors con- 
tributing to a low condition in the general health 
and making any person susceptible whenever these 
conditions are present. On the other hand, a per- 
son who is in perfect health, who pays attention to 
proper breathing exercises, proper diet and bathing 
and who avoids that one great factor — getting over- 
tired — need have no fear of tuberculosis. 



!6 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER II 

Importance of Early Recognition of Consump- 
tion Among the Working Class 

Ninety per cent, of all who have consumption 
belong to the working classes. The following table, 
compiled by the Prudential Life Insurance Com- 
pany, shows the cause of death during the follow- 
ing periods among their policy-holders : — 

NUMBER OF DEATHS FROM CONSUMPTION BY 

DIVISIONAL PERIODS, PRUDENTIAL 

LIFE, 1897 tO I906 



Occupations exposing to 
metallic dust. 

Grinders, 
Polishers, 
Brass workers, 
Tool and instrument 

workers, 
Jewelers, 
Engravers, 
Printers, 
Compositors, 

Totals, 

Occupations exposing to 

mineral dust. 
Stone workers, 
Marble cutters, 
Glass blowers, 
Glass cutters, 
Potters, 
Platerers, 

Totals, 



Ages at Death. 

15 & 15-24. 25-34. 35-44- 45-54. 55-64 65 & 

over. over. 

63 4 17 24 12 5 1 

108 22 42 29 n 4 

161 39 56 41 14 11 



IOI 


13 


35 


24 


21 


4 


4 


113 


24 


44 


22 


13 


7 


3 


67 


12 


29 


19 


5 


2 





613 


167 


247 


140 


42 


13 


4 


59 


6 


36 


12 


3 


1 


1 


1285 


287 


506 


3ii 


121 


47 


13 


302 


10 


60 


82 


9i 


52 


7 


56 





15 


16 


16 


7 


2 


85 


11 


44 


15 


11 


1 


3 


40 


7 


14 


11 


5 


1 


2 


127 


11 


36 


37 


22 


14 


7 


136 


7 


35 


38 


35 


16 


5 


746 


46 


204 


199 


180 


9i 


26 



AND HOW TO PROTECT IT. 17 



Occupations exposing to 


15 & 


15-24. 


Ages at Death. 

25-34- 3S-44. 4S-S4. 


55-64. 6s & 


vegetable fibre dust. 


over. 










< 


jver. 


Spinners, 


56 


13 


19 


16 


7 


I 





Weavers, 


254 


43 


93 


39 


37 


15 


7 


Totals, 


310 


56 


112 


75 


44 


16 


7 


Occupations exposing to 
















animal and mixed fibre dust 














Furriers and taxidermists, 


34 


1 


7 


19 


4 


2 


1 


Hatters, 


278 


42 


97 


84 


34 


20 


1 


Wool and worsted workers, 26 


7 


7 


5 


4 


3 





Carpet and rug makers, 


37 


9 


10 


6 


5 


4 


3 


Silk mill workers, 


106 


28 


32 


33 


7 


4 


2 


Upholsterers, 


118 


15 


38 


38 


18 


3 


6 


Totals, 


599 


102 


191 


185 


72 


36 


13 


Occupations exposing to 
















general organic dust. 
















Millers, 


40 


2 


7 


8 


11 


9 


3 


Bakers, 


277 


43 


86 


75 


43 


23 


7 


Button makers, 


48 


12 


16 


12 


6 


1 


1 


Leather workers, 


206 


35 


77 


55 


29 


9 


1 


Totals, 


57i 


92 


186 


150 


89 


42 


12 


Occupations exposing to 
















municipal or street dust. 














Street cleaners, 


32 





8 


12 


7 


3 


2 


Cabmen and hackmen, 


165 


18 


58 


53 


24 


11 


1 


Letter carriers, 


59 


4 


23 


24 


3 


4 


1 


Street car motormen, 


121 


13 


66 


27 


9 


6 





Totals, 


377 


35 


155 


116 


43 


24 


4 



It will be noticed that the death rate is highest 
during the best years of life. Not more than one 
per cent, receive proper aid at the right time, and at 
least seventy per cent, die unnecessarily. Think of 
it — seven persons out of every ten die because some 
one has blundered, because some one was timid. 

Physicians must educate themselves and then 
educate you. Failure of the physician to grapple a 
case properly at the right moment is responsible for 
forty thousand deaths yearly. Health boards must 
be truer to themselves and to the community. The 
public should insist upon special qualifications and 
greater responsibilities in our health departments. 



18 THE WORKING PEOPLE : THEIR HEALTH 

Everywhere the consumptive, as a rule, is simply a 
neglected victim of tuberculosis. He is the only 
sufferer from disease who is denied necessary relief. 
Physicians must make more painstaking exam- 
inations, and unless they have mastered the methods 
of making a rapid diagnosis, should in the interest 
of humanity turn the case over to some one who 
can make a diagnosis. There is no excuse for treat- 
ing a so-called simple cough for five or six months 
and then turning the patient over for an examin- 
ation to see if he or she cannot be admitted to a 
sanitarium. At the present time the appalling loss 
of life and health constitutes a confession of in- 
eptitude, apathy and neglect. 

There are many reasons why the poor consump- 
tive is the saddest thing in the world. Living as I 
do almost in the shadow of a great state sanitarium, 
I can see the outstretched hands of young men and 
women, asking for what? Asking for a chance to 
be saved in the next decade. It will be the duty of 
the physician, of the philanthropist, and of the cities 
and State to see that this supplication is not made in vain. 

The manufacturers in this great State of Mas- 
sachusetts by their magnanimity and generosity 
have opened up that great field of industrial phil- 
anthropy which must soon link hands with every 
Christian manufacturer in the United States. 

If the physician will recognize the disease in its 
incipient stages and the manufacturer will care for 
the employee in the incipient stages, if the states 
will build more sanitariums for these early cases, 
the sad spectacle of advanced consumption will 
soon disappear from our midst. 



AND HOW TO PROTECT IT. 19 



CHAPTER III 

Going West for One's Health 

The physician who tells you that if you have con- 
sumption you must travel hundreds of miles to re- 
gain your health may be right in a certain number 
of cases, but in eighty per cent. — or in eight out of 
ten — he is wrong. The more I study this disease the 
more I am convinced that there are two vital rea- 
sons why one should consider most carefully this 
question of leaving one's native climate if one would 
accomplish a cure that would be permanent. The 
question of arrest of your disease is small when 
compared with the word permanent — for an arrest- 
ed case in one climate too often turns to a rapidly 
developed case when subjected to changes under 
less favorable climatic conditions. Therefore, be- 
fore sending a patient away from home, the physi- 
cian should ask himself, first, if the case in hand 
can be cured under the conditions and at the place 
he would designate, or whether he simply hopes 
to obtain an arrest of the disease ; and, secondly, is 
it possible that acting upon your advice and making 
use of the teaching which you are sure to give, will 
not the patient be taking less chances if he remain 
at home, where you are sure he or she will receive 
proper treatment ; and if the disease is arrested are 
not the chances better for a permanent cure? 



20 THE WORKING PEOPLE: THEIR HEALTH 

I maintain there are cases arrested and cured in 
home climates which are much less liable to re- 
lapses and advances towards incurable cases than 
those cured or arrested in one climate and then re- 
turned to a different atmosphere. This to my mind 
is an all-important question and one to which the 
physician and patient have in the past given too 
little thought. 

If I had money and early or incipient con- 
sumption, I would consult the best authority upon 
this subject and take his advice about leaving home; 
but, if I did not have money, I would appeal to any 
physician in my city or town who I knew had 
and was taking interest in such as I. I would rely 
upon his judgment and follow his advice, even to 
the minutest detail. 

Times without number in the last few years my 
attention has been called, in my own city, to the 
fact that some husband or brother had been sent 
away to some distant point, had been told that if 
he could reach such and such a place he could se- 
cure employment and get well, only to find when he 
arrived there ten men to every position, and that 
now failing to secure employment, being without 
funds, he must die, because he could not secure the 
money necessary to bring him back. 

Physicians giving such advice are not only in- 
flicting injustice and cruelty upon the patient him- 
self, but breaking the hearts of loved ones left be- 
hind. This practice among the medical profession 
should cease. If you have been careless in your 
early diagnosis (and today there is no excuse for 
this), or if you see the case late, tell the truth. You 



AND HOW TO PROTECT IT. 21 

know, or you should know, that the great western 
states are to-day filled with those sent there by 
some physician. It is bad enough to have con- 
sumption, but it is harder still to stand the taunts 
of some unscrupulous boarding-house keeper, or to 
be pointed at as a "lunger," who is in every one's 
way and who, because "he has not the price," can- 
not get back home. 

The American Medical Association would do 
well to take up this most important question and 
publish a circular to be sent to physicians placing 
before them the reasons why a consumptive with- 
out money should be kept at home. The expres- 
sion, "Oh, go and rough it," is uttered either 
through ignorance or through an improper amount 
of consideration for humanity. If you can rough it 
in the West, you can get well at home. The same 
money spent in railroad fares would pay for a num- 
ber of months at some sanitarium, or some place in 
the country where sanitarium regime can be carried 
out. I hope in the next few years this practice will 
pass into oblivion as far as the doctor is concerned. 
Before you give advice look upon the unfortunate 
as you would upon a brother. If someone is wait- 
ing for you let him wait and remember that five 
minutes' consideration will ofttimes save a life. If 
you find that you cannot speak advisedly send him 
to someone who can; I am now speaking to the 
physician. 

To the patient I want to say, think well of what 
I have written at the beginning of this chapter. 
Remember that a day or two makes no difference 
with your going away, anyhow. In conclusion I 



22 THE WORKING PEOPLE : THEIR HEALTH 

want to say that you stand a much better chance in 
a home climate surrounded by friends, someone 
who cares for you, than you do to travel hundreds 
of miles and then wake up in the morning and find 
yourself surrounded by an unsympathetic people 
tainted by commercialism, chilled by the fact that 
you have two things : Poverty and Consumption. 



AND HOW TO PROTECT IT. 23 



CHAPTER IV 

The Warfare Against Tuberculosis not a 
Hopeless Struggle 

Dr. Edward T. Devine, in his illuminating work 
entitled "Misery and its Causes," gives us his con- 
clusions after a thorough investigation of all the 
facts connected with the cases of 5000 families who 
made application for aid from the Charity Organiza- 
tion Society of New York, in the two years ending 
September 30th, 1908. He finds no less than twen- 
ty-five disabling causes occurring in various combi- 
nations. Of the twelve chief causes for seeking 
charitable assistance, unemployment leads, closely 
followed by overcrowding; widowhood comes next, 
and that in turn is followed by chronic physical 
disability, temporary disability, intemperance and 
laziness. "The impression," he concludes, "with 
which we come to the end of a survey of these 
families is that the average of economic efficiency 
is low, whether it is due to physical disability, de- 
ficiency in character, a low grade of intelligence or 
inadequate education." 

It is the purpose of this book, if it has any pur- 
pose, to make the average of economic efficiency 
high. I have not dwelt intentionally on the weak 
things, the failures or the handicaps of life. There 
are enough writing books of that sort, God wot. I 



24 THE WORKING PEOPLE : THEIR HEALTH 

have not attempted to point out to you ideal and 
impossible conditions, absolutely unattainable by 
the workman earning $1.50 or $2 a day. I have 
tried to say what I had to say in language that even 
a child could understand, and the instruction that I 
have given has been so plain that the wayfaring 
man, though a fool, need not err therein. 

It will doubtless be said by some that the con- 
ditions depicted in this book are only those obtained 
in a highly civilized community, such as Massachu- 
setts is; that breadwinners living in other and less 
favored states cannot have the advantages so 
generously thrown open to the three or four mil- 
lions residing in this Commonwealth. I hope be- 
fore I get through this chapter to point out the 
fallacy of that statement and to show how by mu- 
tual co-operation between capital and labor every 
working-man and every working-woman can be as 
well off, no matter where they live, as the artisans 
and mechanics on the shores of Massachusetts Bay. 
But before I proceed to that, let me call attention to 
a few significant facts. One is that the chances of 
a poor consumptive getting into a first-class institu- 
tion where his case can be cured if it is still in an 
incipient stage grow brighter every day. As a 
matter of fact there are more free institutions for 
the care and cure of those afflicted with tuberculosis 
in the Eastern States than there are institutions run 
on a money-making basis. In the State of New 
York alone there are more than 3000 beds in both 
public and private institutions which are entirely 
free. Massachusetts has at the present time over 
1000 free beds and has, besides, the Rutland Sanita- 



AND HOW TO PROTECT IT. 25 

rium, with a capacity of 400 in that one institution 
at a nominal charge of $4 per week per capita. 

No state and no section have a monopoly of the 
sanitariums. New York has thirty-six; Massachu- 
setts, twenty-five ; Colorado, nineteen ; Pennsylva- 
nia, eighteen; New Mexico, eleven; California, ten; 
North Carolina, nine. In the whole country there 
are two hundred forty (240) of these institutions 
with a capacity of 14,000 patients. And the number 
is constantly increasing. A decade ago there was 
hardly a score. A decade hence not only every 
state but every municipality will be equipped with 
one of these modern life-saving stations manned by 
a crew of devoted scientists armed with every de- 
vice that preventive medicine can suggest to res- 
cue poor human wrecks from the hands of the great 
destroyer. 

For more than a decade now there have been five 
great consumptive Meccas in the United States, and 
like the great German baths the rich invalid has in 
time and in turn tried them all. These are re- 
spectively: the Adirondack region; Asheville and 
Southern Pines, and in general the high piney re- 
gion and sandy soil of the Carolinas ; Denver, Colo- 
rado, and Colorado Springs ; Los Angeles, California ; 
and, lastly, the Southwest, Santa Fe, Albuquerque, 
Las Vegas, Silver City, El Paso, Phoenix and Tuc- 
son. Just at present the Southwest seems to have 
the call. The sanitariums in the Adirondacks are 
excellent — none better. In fact, the one conducted 
by Dr. E. S. Trudeau at Saranac Lake is run by 
the dean and father of us all, the greatest special- 
ist on tuberculosis in this country. His institution, 



26 THE WORKING PEOPLE : THEIR HEALTH 

too, is most reasonable in its charges, only $7 a 
week, but it only contains about 100 patients. It 
is a long, slow process getting admission. White 
House, Pennsylvania, has an excellent institution 
for poor consumptives with a capacity of two hun- 
dred (200), and a weekly charge of $7 to $9. For 
many years Denver and Colorado Springs con- 
stituted literally cities of refuge for those under 
sentence of death by the great white plague, but 
now the tide is turning more and more towards 
New Mexico and the great silent Southwest. In 
those vast spaces, far from the smoke and dust and 
nervous strain of our great cities, men and women 
are drinking in new life and vigor and courage and 
youth. It seems to one breathing that air as if one 
might live forever. 

These New Mexican resorts are as superior to 
those in Colorado as Colorado is to Massachusetts. 
This is not to decry the Centennial State or its 
sanitariums, for they are models of their kind, but 
God Almighty made one climate for New Mexico 
and another for her sister of the North, and by just 
as much as the southern state with its warmer airs 
appeals to those who cannot stand the rigors of the 
Rockies, by just so much will New Mexico obtain 
the supremacy over her earlier rival. Luckily 
there is no feeling engendered by this health-giving 
contest. In a very real and vital sense this rivalry 
for patients is one in which the attempt is made by 
every Commonwealth to demonstrate forcibly who 
best can serve and best agree. 

A most interesting and competent writer in a 
recent issue of a Boston newspaper stated that in 



AND HOW TO PROTECT IT. 27 

the New Mexico College Sanitarium in the course 
of eight years, Dr. E. S. Bullock, the superintendent 
in charge, reported no less than seventy-one per 
cent, of the incipient cases absolutely cured, and of 
the far advanced cases eleven per cent, were saved. 
I do not think under these circumstances any man, 
woman or child who has contracted consumption 
need despair. 

But I think I hear you saying, "Well, Doctor, 
this is all very fine, but when I contract tuberculosis 
I have no money to take me to New Mexico or 
even to the Adirondacks. What have you to say to 
me?" 

I have this to say to you : Go to your employer 
and ask him to write to me and I will explain the 
details whereby more than 20,000 men, women and 
children are protected in this city from the ravages 
of the great white plague in all our stores and 
nearly all our shops by what is known as the "Mer- 
chants and Manufacturers' Agreement." This 
is an agreement entered into voluntarily by our 
merchants and manufacturers whereby they pay 
the charges at our State sanitariums for a proba- 
tionary period of thirteen weeks for any of their 
employees who have fallen victims to tuberculosis. 

By this method, instead of keeping a tuberculosis 
employee at work until it is not only too late for 
him to get well, but he has succeeded in thoroughly 
infecting his fellow workmen, the employee is re- 
moved at the first evidence of the disease and the 
economic efficiency of the entire establishment is 
always kept at high-water mark. 



28 THE WORKING PEOPLE: THEIR HEALTH 

No simpler, saner, surer plan for keeping the 
American workman supreme, physically and 
mechanically, and his product hygienically perfect 
has ever been devised. In the long run, in a com- 
mercial civilization such as the twentieth century 
boasts, the absolutely healthy nation will win. It 
is said that knowledge is power, but I say that 
knowledge unaccompanied by physical health and 
strength is weakness. 

Alexander Stephens was a great man, but Abra- 
ham Lincoln was a greater, for Abraham Lincoln 
could do all the things intellectually that Stephens 
could do, and he could do more — he could split rails 
with his own hands, and he thereby contributed 
something tangible to the assets of the republic — 
a contribution that the eminent Georgian could 
neither add to nor take away. 

I claim nothing for this contribution to modern 
economics, other than the desire to make it known. 
To David H. Fanning belongs the credit for its 
launching. This vigorous old man, who will, Aug- 
ust 4th, 1910, celebrate his 80th birthday, the head 
of a great business, whose ramifications extend 
through both hemispheres, carrying on his shoul- 
ders at four score years a burden that might stag- 
ger a man at half his age, is the author of this plan. 

At a Bryant Festival held in the city of New 
York in honor of his 70th birthday and in response 
to an address by George Bancroft, for many years a 
resident of Worcester, William Cullen Bryant said, 
"Much has been said of the wisdom of old age. 
Old age is wise, I grant, for itself, but not wise 
for the community. It is wise in declining new 



AND HOW TO PROTECT IT. 29 

enterprises, for it has not the power and the time 
to execute them; wise in shrinking from difficulty, 
for it has not the strength to overcome it; wise in 
avoiding danger, for it lacks the faculty of ready 
and swift action by which dangers are parried and 
converted into advantages. What a world this 
would be if it were made up of old men, generation 
succeeding generation of hoary ancients who had 
but half a dozen years or less to live. What new 
work of good would be attempted. What existing 
evil or abuse corrected. What strange subjects 
would such a world afford for the pencils of our 
artist ! Well it is that in this world of ours the old 
men are but a very small minority." 

And yet it was one of these old men who set in 
motion in this agreement one of the most altruistic 
measures of modern times. Many establishments 
have adopted profit-sharing plans by which they 
hoped to incite their help to extra exertions and 
hence greater dividends. Some, indeed, have 
established pensions for their aged, but none have 
risen to the heights attained by David H. Fanning 
when he declared that his responsibility for his em- 
ployees extended to the protection of their health, 
and that he would no more allow disease to steal 
away their employment than he would allow slan- 
der. It was forty-five years from William Cullen 
Bryant to David H. Fanning — a generation and a 
third. Bryant at seventy asked what new work of 
good would be attempted. Fanning at eighty 
answered the question. The great journalist, poet, 
author, wondered what existing evil or abuse an old 
man might be expected to correct, and lo— it was 



30 THE WORKING PEOPLE : THEIR HEALTH 

reserved for one even older to correct the greatest 
physical evil of our times, the abandonment of the 
poor but honest laborer, suffering from the dead- 
liest of all diseases, to a pauper's grave. 

If the manufacturers of this country, north and 
south, east and west, will place their employees, as 
soon as they are found to have the disease in an 
incipient stage, in a sanitarium and will support 
them while there, in a generation we shall render 
consumption as unusual as typhoid fever and as 
harmless. 

'Tis a consummation devoutly to be wished, and 
as we stand here almost at the very portals of the 
promised land and consider the tremendous impetus 
that has been given the practical solution of this 
mighty question by the actions of these manufac- 
turers and merchants of old Worcester County, 
under the leadership of this 8o-year young business 
man, no such gloomy view of life occurs to us as 
occurred to Bryant. Rather are we fain to say, as 
we consider his act and its prophetic results, far 
greater and more important than he himself imag- 
ined when he pledged himself to their execution in 
his business, that he literally builded better than 
he knew. It may be that in his case as in so many 
others — 

"The soul's dark cottage, battered and decayed, 
Lets in new light through chinks which time has 

made; 
Stronger by weakness, wiser men become, 
As they draw near to their eternal home, 
Leaving the old, both worlds at once they view, 
That stand upon the threshold of the new." 



AND HOW TO PROTECT IT. 31 



CHAPTER V 
Patent Medicines and their Effects 

My advice to you is take no patent medicines at 
all. Why? Because patent medicines are gotten 
up to sell ; because patent medicines contain a large 
per cent, of alcohol, and many diseases are made 
worse by the taking of alcohol in any form ; because 
nearly all of these medicines claim to cure nearly 
all diseases, and finally because you cannot diagnose 
your own disease. 

Suppose, for instance, you have a slight cough 
and you at once rush for a so-called cough mixture 
to stop that cough. Now if it should happen to 
be tuberculosis, you do not want to stop it; the 
raising of mucous is the way to get rid of the 
bacilli of tuberculosis, so instead of curing the 
disease, you are helping it on. 

Suppose, again, you are suffering from acid dys- 
pepsia. You may take medicine that contains more 
acid, thus making it worse. Suppose you are suf- 
fering from an inflammation of the bladder due to 
too much acid in the urine. If you take a medicine 
containing acid, as many of them do, and alcohol, 
then you immediately make the trouble worse. 

Suppose, again, that you are suffering from a 
condition of the stomach caused by a sluggish liver. 
Many patent medicines tie up the secretion, which 



32 THE WORKING PEOPLE: THEIR HEALTH 

in this case should be freed. Again you are ner- 
vous and you want a nerve tonic. Now, many of 
the so-called nerve tonics contain a large amount 
of alcohol, while alcohol is just the thing that you 
should avoid. Many a life has been lost, many a 
simple ailment has turned into a chronic disease by 
the taking of things which were just the things 
which should not be taken. Your health is one of 
the things you must strive to maintain. Why? 
Because it means dollars and cents to you, and its 
impairment means a crushing burden of debt. In 
this enlightened age we must seek to prevent sick- 
ness rather than cure disease. 

If you do not feel well, you want to know what 
the matter is, and no one can tell you better than 
a qualified physician. Perhaps you are saying to 
yourself at this point: "Oh, well, you doctors say 
that and you run down patent medicines because 
they hurt your business/' That is not true. Pa- 
tent medicines help the doctor. It is not in the 
treating of acute diseases doctors make their money; 
it is in the chronic diseases which they are called 
upon to attend. That is where they reap their 
harvest. 

I am simply addressing you because I have prom- 
ised to show you how to protect your health. If 
space permitted, I might take up a list of medicines 
advertised to cure nearly everything and show you 
where in your individual case the medicine would 
be just what you should not take; that instead of 
curing you, it must simply make you worse. Hap- 
pily, as I write, patent nostrums are being sold less 
and less, and as people become more enlightened 



AND HOW TO PROTECT IT. 33 

they are taking less and less of them, because they 
are commencing to think for themselves. 

In conclusion I want to repeat what I have al- 
ready said, and that is, if you prize your health and 
the health of your family, let all patent medicines 
alone and take medicine only when prescribed by 
a reputable physician. Live so that you will not 
feel the need of medicine. Avoid the vicious habit 
of rilling up on medicine every time you feel in- 
disposed. It is harder to break that habit than the 
habit of intemperance or cigarette-smoking. 

If disease actually exists it must be treated, not 
by a shotgun, but by the application of science. 
The Circle in the November, 1909, issue, gives the 
following as a result of taking patent medicines: 
30,000 cases of poisoning, 40,000 cases of addiction 
to the drug habit. Eight thousand deaths result 
annually from taking patent medicines. 



34 



THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER VI 

The Home as a Sanitarium 

If you are poor and have no means, your home 
must be your sanitarium. How shall it be arranged 
to be most effective in helping you regain your 
health? Many times within the last ten years 
have I been brought face to face with this question, 
"Can I get well at home"? The answer should al- 
ways be, "Yes." Why? Because the germs of 
tuberculosis are the most inactive of all germs. 
The term "galloping consumption" is a misnomer. 
True, the disease seems at times to work quickly, 
but in these cases it has been lying latent in the 
system, getting its root, as it were. It has been 
unrecognized, treated for simple bronchitis or a 
little "run down" condition, when suddenly it 
springs into life and comes on with a mad rush. 
There is no time to be lost either waiting for a 
vacancy at some sanitarium or waiting until you 
get a little stronger. You must begin action at 
once. 

Let us see how we can imitate a sanitarium, using 
the home in summer. We must keep the house 
opened and screened. Sleep if possible on the 
piazza, or if this is not practical, use the roof. 
Keep in a reclining chair in the open air. If you 
can afford it get a half tent. This consists of a 



AND HOW TO PROTECT IT. 35 

frame of steel tubing which can be folded. together 
when not in use. Your physician can easily in- 
struct you how this can be made. Stay o-ut of 
doors, except at such times as the weather will not 
permit. Mind and body must be at rest; don't 
worry. Follow closely the instructions of your 
physician or district nurse relative to eating, sleep- 
ing and bathing. In cold weather the bed must be 
covered with a sufficient number of blankets to as- 
sure comfort and warmth throughout the night; 
still the covering should not be so heavy as to press 
down upon the body. If blankets cannot be ob- 
tained, put several layers of newspaper between 
two layers of dark-colored flannel. The so-called 
Klondike bed can be constructed very cheaply; the 
method can be obtained from any anti-tuberculosis 
society in your city or town. In these days, upon 
application to any of these societies, full information 
will be given. 

Before establishing your home sanitarium it is 
always best, if in the city, to call upon the tuber- 
culosis nurse who will give you full instructions ; if 
in the country, you can practically live out of doors 
and that settles the question. If you desire more 
complete information, a line sent to any society for 
the prevention of tuberculosis, of which there are 
now over three hundred in the United States, will 
bring you all the information necessary. Then 
place yourself in the hands of some physician rec- 
ommended by this society, for they are closely in 
touch with all physicians doing this work. Ten 
minutes' instruction from a physician who has made 
a study of this disease will give you all the details 



36 THE WORKING PEOPLE: THEIR HEALTH 

necessary to begin with. He will then advise you 
at each visit if there are any changes necessary to 
be made. Follow his instructions carefully; re- 
member your physician is interested in your case, 
no matter what your circumstances. I have yet 
to find a town where there is not some kind-hearted 
person who is willing to assist you and give you 
advice. They in turn can procure for you printed 
instructions relative to food, exercise, bathing, 
sleeping, etc., which you may read and follow. 

Nearly every library now has books upon this 
subject which can be procured and read. Getting 
well at home means the following out to the minut- 
est detail of the instruction imparted to you ; much 
depends upon yourself. At a sanitarium you get 
well because you are obliged to follow minutely 
every rule laid down. At home, you get well by 
following to the very letter the advice given you. 
It is your own life that is at stake. 



AND HOW TO PROTECT IT. 37 



CHAPTER VII 

Consumption Among School Children— its 
Cause and Prevention 

In 1904 through the daily press I strongly ad- 
vocated a course in school hygiene, supplemented 
by physical examination of school children. I have 
also at different times called school authorities' at- 
tention to the fact of poor ventilation of school 
buildings as a predisposing factor in tuberculosis. 
My conclusion was drawn by observation made 
during seven years while a member of the Board 
of Education of this city. I now say that school 
buildings in many cities are the poorest ventilated 
of all public buildings, and early in January of this 
year, before a body of 700 educators, in a paper 
read by me, I pointed out the necessity of better 
ventilation and its relation to health, not only of 
the present generation but of the men and women 
of to-morrow. 

The present curriculum of our public schools is 
overcrowded. The present system of education, 
coupled with poor hygienic surroundings, is send- 
ing out into the world too many physical wrecks; 
a more thorough system of physical examination 
among school children is needed. The results of 
various investigators are at variance as to the exact 
prevalence of tuberculosis among school children, 



38 THE WORKING PEOPLE: THEIR HEALTH 

yet all agree upon the question of better school 
hygiene, coupled with a course of proper school 
gymnastics, supplemented by thorough and pains- 
taking examination, and the separating of the weak 
from the strong. 

It has been my decided opinion for the last seven 
years, unless the present school system undergoes 
a change, as the years go on our national vitality 
will suffer in consequence. 

For many of the statistics in this chapter I am 
indebted to School Document No. 2, submitted by 
a commission appointed by the School Committee 
of the city of Boston. The researches of this com- 
petent body bear out my assertion made in this 
chapter and at previous writings. The report fol- 
lows : 

REPORT OF THE COMMISSION APPOINTED BY THE 
SCHOOL COMMITTEE OF THE CITY OF BOSTON TO 
INVESTIGATE THE PROBLEM OF TUBER- 
CULOSIS AMONG SCHOOL CHILDREN 

(School Document No. 2, 1909.) 

"Mr. David A. Ellis, 

Chairman Boston School Committee. 

"Sir: The report of the commission appointed 
by the School Committee of the city of Boston 
to investigate the problem of tuberculosis among 
school children is respectfully submitted herewith. 

"This report is based on an estimate of the num- 
ber of tuberculous children in our public schools, 
and the evident necessity for special provision for 



AND HOW TO PROTECT IT. 39 

their care. Various careful investigations in other 
communities have given us a reasonably accurate 
basis for the conclusions which are given below. 

"The results of numerous investigators are some- 
what at variance as to the exact prevalence of tuber- 
culosis among children. Many trustworthy author- 
ities, notably the French and German, believe that 
infection with tuberculosis is nearly always acquired 
in early life; that during childhood the tuberculous 
focus often remains inactive; that as the child 
reaches adolescence and is submitted to the con- 
finement and strain of school life, or in adult life 
meets the strain then put upon him, the lessening 
of the body resistance is sufficient to permit the 
organisms to gain the upper hand, and active tuber- 
culosis in some form develops. This view seems 
to be gaining ground. 

"The most exact and trustworthy information is 
furnished by autopsy statistics, of which an abun- 
dance is available. 

"Grancher (Paris) says: The great majority of 
children who come to autopsy in hospitals show 
tuberculosis of the bronchial glands, not recognized 
during life/ Naeglli (Germany) found 33 per 
cent, of all children coming to autopsy to have tu- 
berculosis of the glands. Among 1432 autopsies on 
children in the hospitals of Paris during the past 
four years, Comby found 429 tuberculosis subjects, 
or approximately 37 per cent. He further found 
that the percentage of infections rapidly increased 
with the age ; that is, for the first two years of life, 
25 per cent, were tuberculous ; the third year, 45 
per cent.; fourth year, 50 per cent.; fifth year, 60 



40 THE WORKING PEOPLE : THEIR HEALTH 

per cent.; sixth year, 65 per cent. Similar statistics 
were obtained by Wollstein, pathologist at the Ba- 
bies' Hospital, New York city. One hundred and 
eighty-five of 1,113 autopsies on children under four 
years showed tuberculosis. Twelve per cent, of all 
under one year were tuberculous, while during the 
second year 33 per cent., and in babies over two 
years, 34 per cent, were affected. 

"This marked increase in the percentage of deaths 
due to tuberculosis during the first years of life 
is even more definitely shown by the following: 
Kirschner has compiled a table based upon Prussian 
statistics, giving the number of deaths from tuber- 
culosis in each 100 deaths, grouped according to 
sex. This table brings out the significant fact, now 
generally accepted, of the greater prevalence of tu- 
berculosis among girls in the first years of life: 



In Year. 


Males. 


Females. 


Total. 


0-2 


I.6l 


I.60 


100 


1-2 


446 


4-55 


100 


2-3 


5.84 


6.48 


100 


3-5 


6.44 


7-41 


100 


5-io 


9.26 


12.02 


100 


10-15 


18.65 


2974 


100 



"Dunn has combined all available statistics of the 
percentage of deaths among children shown at post- 
mortem examination to be due to tuberculosis. 

First three months, 0-2 per cent. 

Second three months, 16-17 per cent. 

Second six months, 22-26 per cent. 

1-2 years, 42-44 per cent. 

2-10 years, 67 per cent. 

10-15 years, 64-67 per cent. 

"It may very reasonably be objected that such 
mortality statistics do not truly represent the prev- 



AND HOW TO PROTECT IT. 41 

alence of tuberculosis among children, since they 
are based on deaths among children in hospitals 
only. On the other hand, as has been shown by 
several writers on the subject, the figures fall far 
below the actual percentage of tuberculous children, 
and must be considered as a minimum; for it must 
be remembered that many children survive their 
early tubercular process and either remain perma- 
nently well or succumb to a fresh outbreak of the 
disease in later life. These cases, therefore, do not 
appear in any statistics derived from autopsies 
among children. Tuberculosis in early years of life 
is far less fatal than in adults. 

"Though more difficult to obtain and considerably 
more inaccurate, the clinical investigations upon the 
prevalence of the disease previous to the fifteenth 
year probably come more nearly to the facts. 
Among the many published during the past few 
years, the following may be taken as the most trust- 
worthy. The use of the newer methods of diagno- 
sis, and particularly the recent employment of tu- 
berculin, have made possible a more accurate study 
of this problem. The results have been most sur- 
prising, in that they have brought to light far 
greater frequency of tuberculosis in infancy and 
childhood than was previously suspected. 

"In 1907 Lowman found 100 children with tuber- 
culosis in 500 children examined at the tuberculosis 
dispensary in Cleveland, Ohio, and he did not use 
tuberculin. He further showed by statistics that, 
contrary to the previous teaching, the chief danger 
to school children lies, not in the ordinary con- 
tagious diseases, but in tuberculosis. 



42 THE WORKING PEOPLE: THEIR HEALTH 

"Roux and Jasserand, working among the school 
children in Paris, found 40 per cent, of those exam- 
ined with signs of the disease. Pulmonary tuber- 
culosis was present in 29 per cent, of 2295 children 
in New York, examined by Dr. Williams during 
the year 1905-06. 

"Recently Floyd and Bowditch studied 1000 cases 
in the outpatient department of the Boston Con- 
sumptives' Hospital, and state that about 36 per 
cent, of these presented definite pulmonary lesions, 
and that about 30 per cent, more gave evidence 
through signs and symptoms of tuberculosis else- 
where. Sixty-seven per cent, of these were chil- 
dren of tuberculous parents. 

"Philip has made a careful examination of groups 
of children in various public schools in Edinburgh, 
the children being selected at random by the head 
masters and without reference to their physical 
condition. Thirty per cent, were found to have 
definite stigmata of tuberculosis. 

"Miller and Woodruff found 51 per cent, of 150 
children of tuberculous parents to be positively tu- 
berculous. Sachs, in a similar investigation of 332 
children, found 89 per cent, to be tuberculous. 

"Recent studies demonstrate, contrary to the pre- 
viously accepted opinion, that tuberculosis in child- 
hood, as in adults, most frequently affects the 
lungs. It is a fact, however, that the bones, glands, 
joints, intestines and other organs and tissues are 
much more frequently affected in children than in 
adults ; but considerable evidence of a reliable char- 
acter has been collected which would seem to in- 
dicate that even tuberculosis of these tissues and 



AND HOW TO PROTECT IT. 43 

organs is usually secondary to primary tuberculosis 
of the lungs. 

"Several general facts in regard to the nature of 
the disease in early life should be stated because 
they indicate the appropriate measures to be 
adopted. First, children are much more susceptible 
to infection with the tubercle bacillus than adults; 
second, the presence of the disease in children is 
very often less evident; third, the disease is in a 
much smaller percentage of cases fatal ; fourth, the 
disease more frequently remains in a dormant or 
latent form than in adults. In this form it is prob- 
ably the real cause of very many sickly, poorly de- 
veloped and backward children. 

"No argument is necessary to show that the dan- 
gers of infection in infancy and childhood are 
greater than those in later life. The sources of 
contagion are evident. The portal of entry of the 
tubercle bacillus is still a question on which there 
is a wide difference of opinion. On the one hand, 
it is held that the organisms commonly gain en- 
trance to the body through the intestinal tract by 
means of infected or contaminated food, while, on 
the other hand, the lungs are believed to be the 
portal of entry. In either case, the sources of in- 
fecting germs are essentially the same, and the 
methods of prevention are identical. 

"Clinically, tuberculosis may be roughly divided 
into two classes : the closed and the open. By 
'closed tuberculosis' is meant those cases in which 
the tubercle bacilli are not thrown off from the 
body, and these cases are not to be considered as 
dangerous to others, in the sense of being infecting 



44 THE WORKING PEOPLE: THEIR HEALTH 

foci. In this group may be included the majority 
of those with bone, glandular, meningeal, spinal 
and intestinal tuberculosis, hip disease, scrofula, and 
many cases in which the lungs are involved, but 
the process is not active or not advanced enough 
to give rise to much, if any, expectoration. The 
majority of tuberculous children fall within this 
closed class. 

" 'Open tuberculosis' includes all cases of con- 
sumption in which through expectoration tubercle 
bacilli are thrown off from the lungs and such cases 
of tuberculosis of other tissues as to give off tuber- 
cle bacilli through the medium of discharged matter. 
Here, in consequence of the danger to others, 
prophylactic measures are of the first importance. 

"The more infecting cases of this latter class for- 
tunately represent but a small proportion of the 
children, and since they are usually too sick to at- 
tend school, offer no great burden for the school 
authorities. The consideration of these cases be- 
longs to the School Committee only so far as to 
see that they are strictly excluded from the schools. 
The duty of caring for these should be assumed by 
the health authorities. 

"For the earlier cases (most of which are still 
closed tuberculosis) the commission believes the 
School Department should make special provision, 
as such children can be restored to health while 
regularly attending school. Their progress in their 
studies is obviously as a rule slower than in the case 
of healthy children, and the standard of the work is 
thus inevitably lowered. A second and even more 
important reason for furnishing separate and special 






AND HOW TO PROTECT IT. 45 

instruction for this group is that under the ordi- 
nary routine many of them sooner or later break 
down, or are in such poor health that they do not 
derive proper benefit from the money expended on 
them by the community. This economic loss to 
the community in the case of school children with 
tuberculosis seems to your commission to be one 
of the important reasons why they should be sepa- 
rated and given special instruction under conditions 
particularly suited to build up the general health. 
Statistical studies are not wanting to fortify this 
position. A single quotation will suffice. In Illinois 
it was recently shown that the State each year ex- 
pends $1,187,000 in educating children who die of 
tuberculosis before reaching the twentieth year 
(Thomas). 

"Instead of allowing the tuberculous to become 
defectives, they may with few exceptions through 
proper care during the school years be cured and 
made useful citizens. 'To provide properly for the 
tuberculous is enlightened policy; to provide for 
the defective is charity/ (Lowman.) 

"Children are extraordinarily susceptible to fa- 
vorable and unfavorable influences, and with the en- 
trance into school many conditions unfavorable to 
health must be faced, conditions which in a general 
way favor the development of tuberculosis. The 
most convincing example of this is seen in the fre- 
quency with which the so-called 'pre-tuberculous* 
or the suspected cases manifest evidences of active 
tuberculosis before the termination of their school 
years. These should be shielded from overwork, 
developed physically under medical direction by 



46 THE WORKING PEOPLE: THEIR HEALTH 

the most careful and intelligent regulation of the 
hours in the open air, provision for the most per- 
fect ventilation and by proper feeding. 

"As stated at the beginning of this report, we have 
no definite figures as to the number of tuberculous 
children in the public schools of Boston. The 
examinations made in the out-patient department 
of the Boston Consumptives' Hospital (Floyd and 
Bowditch), however, where the tuberculin test was 
employed, have shown a considerable proportion of 
debilitated and undeveloped children, especially 
those from tuberculous families, to be tuberculous. 
Of the class not strictly tuberculous, but sickly and 
poorly nourished, and consequently favorable can- 
didates for infection, there are unquestionably a 
large number, and for these special provisions, to 
the end that they shall be built up physically, are 
of as much importance as for the strictly tubercu- 
lous. 

"Your commission believes that 5000 is a con- 
servative estimate of the total number of tuber- 
culous children in the public schools of Boston. 

"The Boston Association for the Relief and Con- 
trol of Tuberculosis opened in July a day camp for 
tuberculosis children. In September the day camp 
was converted into an outdoor school in conjunction 
with the School Department. Thirty-one children 
have been at the camp or school a month or more. 
Of these, sixteen have been considered by the 
examining physicians to have had their tubercular 
process arrested, have been discharged and recom- 
mended to return to the ordinary school; four have 
been discharged because they moved from Boston 



AND HOW TO PROTECT IT 47 

or for other reasons; in two the disease was so 
advanced they were sent to a hospital. 

RECOMMENDATIONS 

"In view of the considerations above presented, 
your commission respectfully offers the following 
recommendations : 

"1. That more systematic and thorough examin- 
ation be made of all suspicious children and of all 
found to be of tuberculous parents. 

"2. Those already infected they would divide 
into classes, and make recommendation as below 
given : 

"Class 1. Those cases already well advanced, 
which do not belong in the schools at all, as pre- 
viously stated above. 

"Class 2. Less advanced, but definitely tubercular, 
both open and closed. Here the problem is primar- 
ily one of health, and education should be the sec- 
ondary consideration if the two conflict. For these 
the commission would recommend outdoor schools, 
with the belief that by this means the child may be 
restored to health without loss of instruction. The 
outdoor school means a life in the open air, the 
proper and sufficient feeding of the child and the 
providing of suitable warm clothes, etc. The com- 
mission recognizes that the feeding of one group 
of children (the tubercular) by the School Depart- 
ment introduces a new matter into the problems of 
the School Department and one fraught with se- 
rious difficulties. The commission would suggest 
that these children might be placed under the care 



48 THE WORKING PEOPLE: THEIR HEALTH 

of a hospital department, which would furnish food, 
clothing, etc., as for any other patient, the School 
Department merely keeping school for them, and 
as is now done in connection with the Association 
for Relief and Control of Tuberculosis. Indeed, the 
Boston Consumptives' Hospital department now 
maintains a day camp, where many patients come 
every day, receive all their food, etc., and go home 
at night. The addition of a school for these, were 
they children, would seem proper and just. 

"The commission regards the results obtained in 
the present outdoor school as most encouraging. 
The first of these schools in America was at Provi- 
dence last year. This year a number have been 
opened, but none known to the commission have so 
many pupils as the school at the Franklin Park 
Refectory. 

"Class 3. A large class, where the tubercular pro- 
cess is not so evident nor so advanced as to give 
rise to definite symptoms — the 'sickly* child, the 
'scrofulous' child, and in many cases of closed but 
definite tuberculosis — can be included here. This 
class needs care and management quite similar to 
the last, but not necessarily carried so far nor so 
different from that of an ordinary school. These 
should remain entirely under the School Depart- 
ment. For them it would be wise to have in every 
schoolhouse an open-air room where the windows 
are always open, where the consideration of health 
is given as much or more attention than that of 
learning. 

"A child spends a large part of its life in the 
schoolroom. Strong, healthy children are those 



AND HOW TO PROTECT IT. 49 

that have spent the most time in the open air. Life 
in the open air is the best investment one who is 
not strong can make. The nearer the schoolroom 
can approximate to the open air, the larger will be 
the return to the city on its investment in schools. 
There would seem to be need in all schoolrooms 
of a more abundant supply of fresh air; of main- 
taining rooms at proper temperature, and the lower 
the better the air; of proper, sufficient and hygienic 
method of dusting, frequently done ; of the frequent 
washing of rooms ; of frequent and prolonged airing 
of all parts of the schoolhouse by open windows, 
and every means employed to the end that the place 
and air where the child spends so much of its life 
be as near as possible that of outdoors in a dustless 
region. 

"Finally, the commission strongly recommends 
that a further experiment with an outdoor school on 
a larger scale be tried next year, and that for this 
purpose some suitable building be selected. 

"The commission will gladly further assist in this 
matter in any way that it can, should the School 
Committee so desire. 

"JAMES J. MINOT, M.D. 
CLEVELAND FLOYD, M. D. 
THOMAS J. LEEN, M.D. 
EDWIN A. LOCKE, M.D. 
ELLIOTT P. JOSLIN, M.D." 



50 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER VIII 

The Importance of Early Attention to 
Catarrh in Children 

Mothers have now heard so much about en- 
larged tonsils and adenoids and their relation to the 
health of a child, that it seems hardly necessary for 
me to say that every child should be examined 
at an early age for these two growths, and if found 
should be at once removed. Your child's health 
will be so much improved after this operation that 
you will advise all your friends who are mothers 
to follow your example. But the most important 
disease of the nose and air passage does not re- 
ceive the attention that its importance as a source 
of ill health demands. Many of these catarrhal dis- 
eases begin as early as the first year of infantile 
life, and while not necessarily dangerous to life, 
they have a serious effect upon the development of 
the child, and are often the very things which 
start chronic diseases and leave their mark upon 
the man or woman in adult life. Just as sure as 
you neglect these diseases, you will find your mis- 
take a little later on. A mucopurulent discharge 
from a child's nose should never be let alone, but 
should be treated at once. The assertion that a 
child will grow out of it and that nearly every 
child has catarrh in this climate is all nonsense. 



AND HOW TO PROTECT IT. 51 

The child may apparently get better, but it will 
never get well. The getting better simply means 
that the disease has changed form. The state- 
ment that nearly every one has catarrh in this 
climate would be given the lie if we treated the 
catarrhs of childhood. As it is to-day owing to 
neglect, it is a fact that many do have catarrh; 
however, the cause is not the climate, but neglect. 

Only a few years ago physicians were sending 
every one out of New England to be treated for 
early consumption; to-day it has been conclusively 
proved that we can cure as many cases in New 
England as in almost any other climate. 

The effect that neglected catarrhal inflammation 
of the upper air tract has upon the ears is cer- 
tainly important. Many of the best specialists, in- 
cluding Knapp, tell us that if a child escapes ear 
disease during childhood, he is safe for the rest 
of his life, barring accident. The ears are more 
likely to be affected by inflammation of the nose 
and throat than any other organ, and this is espe- 
cially true during childhood. There are a score of 
reasons for this. Children are very likely to have 
inflammation of the nose and throat, and they rarely 
ever know how to clear the same, and if this secre- 
tion is retained, it keeps up a state of chronic in- 
flammation for many months, and this alone is a 
fruitful source of disease of the middle ear. The 
so-called purulent rhinitis, or catarrhal condition, 
may exist with adenoids as it may exist without. 
If caused by adenoids it will disappear upon re- 
moval, but if it is a separate diseased condition the 
removal of adenoids will not effect a cure, and the 



52 THE WORKING PEOPLE: THEIR HEALTH 

catarrh must be treated. It will never be out- 
grown. If we would stop middle ear disease in 
children, we must treat the catarrh. Catarrh can 
be cured. 

Bosworth has maintained for many years that 
atrophic rhinitis in adults, causing such foul 
breaths, was due to an untreated case of catarrh 
of childhood, and the studies of Grunwald made 
in the last few vears seem to confirm the opinion 
of Bosworth. 

Now you will ask me in what way and to what 
extent catarrh will affect the general health. First, 
it interferes with sleep; the child will be anemic 
and pale because the blood does not receive suffi- 
cient oxygen; the chest will not be developed and 
the nervous system must suffer. Mouth breathing 
causes bronchitis ; the digestion is interfered with, 
due to the swallowing of large quantities of muco 
pus, which is constantly present in the nose and 
throat, and which they have not the knowledge and 
ability to expectorate. The cervical glands be- 
come affected from this inflammation, and much of 
the so-called scrofula is due to this same cause 
(endocarditis heart disease), and acute rheumatism 
is caused by products of a tonsilar abscess gaining 
access to the general circulation. 

The subject seems to me to be of the utmost 
importance to you, mothers and fathers; it should 
not be lightly passed over, for the effects are passed 
on to manhood and womanhood, causing many 
times, along with the other diseases that I have 
mentioned, loss of hearing, which we all abhor. 



AND HOW TO PROTECT IT. 53 



CHAPTER IX 
Are We All Tubercular? 

My conclusion, based on a careful study of this 
subject for the last ten years, is that 90 per cent, 
of all human beings are tubercular at some time 
during life. Naeglli reported, after an exhaustive 
study of this subject, that a careful examination of 
a large number of bodies in the autopsy room had 
convinced him that in at least 90 per cent, of all 
bodies examined, he found tubercular lesions. 
Burkhardt found in the material investigated at 
Dresden about the same proportion as Naeglli. 
Lubarsch placed the percentage at 70 per cent. 
Nucker's figures v/ere about the same as Lu- 
barsch's. The latest contribution to this question 
is by Bertzke, who had examined 1100 bodies in 
Berlin. His results are somewhat lower and he 
believes that Naeglli's statement should read, "In 
the autopsy material of large cities nearly every 
adult body is tubercular." 

Certain it is today that many of the deaths from 
pneumonia are simply tubercular processes. And 
the death certificate should read tuberculosis in- 
stead of pneumonia. Many so-called catarrhal 
apendicts, if a microscopical examination was made, 
would show the tubercle bacilli. We have paid too 
much attention to the mere cutting in surgery and 



54 THE WORKING PEOPLE: THEIR HEALTH 

not enough to the microscope and clinical symp- 
toms. The next few years the study of preventive 
medicine will save much cutting, which in the past 
has developed into a craze among certain members 
of the medical profession. 

It has been estimated that in ten years in the 
city of New York alone, twenty thousand women 
were unnecessarily unsexed, and their health in 
over 60 per cent, of the cases has never been re- 
gained. Please do not understand me to say that 
I do not believe in surgery, for I do. It has re- 
lieved untold suffering and saved many lives. But 
we Americans have been too willing to cut. The 
hospitals of the future will pay more attention to 
bacteriology and the application of clinical knowl- 
edge than they do to* the so-called exploratory 
incision, which means cutting with a hope of find- 
ing something that the clinical symptoms do not 
reveal. 

Tuberculosis of the joints in children is often 
treated for rheumatism and a course of massage is 
advocated, when the limb should be put in light 
plaster casts and kept at rest. Understand, also, 
that I do not think that every ailment, medical or 
surgical, is tubercular. But when the autopsy table 
reveals in about 90 per cent., lesions active or 
healed, then I say it is about time that we should 
pay more attention to the study of this disease. 

No wonder it has been called the Great White 
Plague. Physicians have got to learn, as well as 
the laity, that certain natures are susceptible to 
this disease, and these persons should be carefully 
watched. 



AND HOW TO PROTECT IT. 55 

Huber says, in commenting upon it in the open- 
ing chapter of his book, that it is with a sense of 
melancholy one contemplates the long death roll of 
tuberculosis from which the world's great men and 
women have succumbed untimely. He further 
says that had it not been for this detestable par- 
asite, Bastien-Lepage might have given us an- 
other' Joan of Arc to feast our eyes . upon ; Rachel 
might for many years have continued to permeate 
her audience with the spirit of divine fire; Paul 
Jones might have added zest to our War of 1812, 
and more of the splendid war stories of Stephen 
Crane might have been written; Robert Louis 
Stevenson's delightful lace-work might have been 
continued; another "Song of the Bells" might have 
been written by Schiller; John Keats might have 
given us another Endymion, Nevins another "Ro- 
sarie;" Von Weber another Euryanthe overture; 
Chopin might have dreamed another First Polon- 
aise, and the tender notes of Sidney Lanier might 
even now be heard. Henry Purcell, John Sterling, 
Henry Timrod, Artemus Ward, Henry Kirke 
White, Thoreau, — such names are but a moiety 
amongst those of the world's nobility whose pre- 
cious lives were cut off by the Great White Plague. 
Meditate for a moment upon these wonderful per- 
sonalities, interwoven with music, art, courage and 
power, and remember that genius like that is as 
irreplaceable as Shakespeare himself, and once 
gone is gone forever. 



56 THE WORKING PEOPLE : THEIR HEALTH 



CHAPTER X 

After the Sanitarium or Preliminary Rest- 
cure at Home, What Next? 

For the subject text to this chapter I am in- 
debted to the "Journal of the Outdoor Life" of 
May, 1909. I would ask each reader of this book 
to follow closely the directions for maintaining 
your health, already gained perhaps by a struggle 
and more or less expense and anxiety. Do not 
allow yourself by carelessness to lose what you 
have gained and which justly belongs to you. Add 
to, if possible, rather than draw from your capital, 
which is your health. An empty purse is bad 
enough, but a future devoid of health is a bank- 
ruptcy from which one is never discharged. 

The following article is written for the patient 
who for some months has been taking the rest-cure 
at a sanitarium or under a physician's supervision, 
and has been told that it is safe for him to go back 
to work or take up in a measure the old manner 
of life. It is not written for the patient who has 
just fallen ill and whose disease is in an active 
stage; this patient requires fuller instruction and 
will only lose time if he does not begin at the 
beginning — that is, give up everything for a few 
months at least and take the cure as it is taken at 
a well-ordered sanitarium. 



AND HOW TO PROTECT IT. S7 

When the tuberculosis patient leaves the sanita- 
rium or health resort after a longer or shorter stay 
and returns to his old surroundings in town or city, 
he has a great many problems before him and his 
mind is filled with uncertainties. He feels a timid- 
ity not unlike that which every boy or girl feels on 
first leaving home and starting out to tussle with 
the world alone. In the sanitariums he has had 
about him conditions which made it easy for him to 
do the things that build him up: a free open-air 
life, opportunity for abundant rest, and people all 
about him doing the same things that he must do. 
Also, he has more or less constant medical super- 
vision and a physician to turn to whenever he was 
in doubt about anything. But now on reaching 
home, so many things are exactly the opposite of 
this. In many cases he has to work every day, 
oftenest in shut-in places, as offices, schools or 
stores, and, most difficult of all, the people about 
him, both at work and at home, are healthy people 
who do not need to be careful. You will find your- 
self wishing many times for someone who, like 
you, is not quite strong and must be careful. How 
often, too, you will think, as you work away, sur- 
rounded by wooden desks, stools and chairs, all 
straight-backed and stern, in rooms none too well 
lighted, where the air is often warm and stuffy, of 
your old sanitarium porch with its reclining chairs 
and comfortable beds, fresh air all about you, and 
sky, mountains and rivers that used to be so good 
to watch. You are back in the work-a-day world, 
and holiday time is over. Your endurance is an 



58 THE WORKING PEOPLE: THEIR HEALTH 

uncertain quantity because it is hard to foretell how 
much it will be taxed. 

A danger with many people is that they feel per- 
fectly well and are apt to forget that they are not 
quite so; in tuberculosis the symptoms may all 
cease before the disease is really cured. Don't be 
impatient and try to do everything at the start if 
you wish to keep on getting stronger. Remember 
that the best things in life require patient working 
for, and to become a cure is no exception to the 
rule. It is the patient who has the pluck to deny 
himself pleasures, such as theatres, dances and late 
hours, who is going to keep well and be able to 
remain at his work. 

For some it will be wiser to give up the old 
indoor occupation and take an outdoor one. This 
is sometimes difficult to get and often requires cap- 
ital. Among other things that may be done are 
truck gardening, raising chickens or squabs, driv- 
ing, farming, or surveying. 

Strange as it may seem, you will find that your 
friends and your own family are perhaps one of 
the factors that make things most difficult on re- 
turn to the old life. You come home fat, ruddy 
and with all the outward signs of perfect health, 
and it is almost impossible for them to realize that 
these things do not mean perfect health. It is 
easy to understand why they should not, because 
after most illnesses that are seen every day, these 
things are the criterion of recovery. Your friends 
want you to do so many things that are not wise, 
and if you refuse they often lay it down to over- 
cautiousness, or even selfishness when you look 



AND HOW TO PROTECT IT. 59 

so perfectly well. Your family may make it diffi- 
cult for you to sit out or take the cure, either be- 
cause they want you to be indoors with them or 
because they have the old-fashioned ideas about 
dampness and cold being dangerous. 

The routine of the sanitarium is often the hard- 
est thing for you to submit to. When you get 
home, it is almost impossible not to fall back into 
your old habits. The easiest things to do are the 
things you have always done: your home habits 
are the product of all the years of your previous 
living; your sanitarium habits are the product of 
only a few months of routine life. Sanitarium 
living is well-ordered and wise, but often seems 
very humdrum, and you must use all your will- 
power to keep it up at home. At the end of your 
day, or in your leisure time, you will often be 
greatly tempted to go out and have a little excite- 
ment, as at the theatre, a dance, or a lodge meet- 
ing; to dine out and stay up late; to spend Sun- 
day shut up in the house smoking, reading the 
newspapers, and eating. These are the things you 
used to do as a rule, and they are the things you 
are only too prone to fall back to when you have 
been long enough from the sanitarium for the 
teaching you received there to become rather hazy 
in your memory. 

The first weeks and months are the most diffi- 
cult. If you meet these right, you will feel the 
ground firmer and surer under your feet as the 
days go by. When possible, do not let anything 
hold you back. The first few months do absolute- 
ly nothing outside of your work that you are not 



60 THE WORKING PEOPLE: THEIR HEALTH 

obliged to do. Never let yourself get tired out, and 
don't go ahead on your nerves. Rest all you can. 
Form a habit, whenever you can stop for awhile, 
not of just sitting down, but of lying out flat. This 
relaxes every muscle and is of great value even if 
it is only for a few minutes at a time at intervals 
during the day. If you do these things the first 
days and the first weeks, you will not tire ; you will 
not be discouraged each night by feeling done up, 
and as days and weeks go by you will feel you are 
able to live in the old conditions and gain confi- 
dence in yourself. By slow degrees you can do 
more. 

Sleep is such a big factor when you first go 
back. Get just all you can of it, and the best way 
is to get to bed early; form a habit of it, and do 
not let little things break in. Getting to bed early 
will be one of the hardest things to do, but it pays 
many times by the feeling of freshness and 
strength it gives you for the busy hours. Some 
people who are less busy, or who are in their 
homes, will find an after-dinner nap a great pick- 
me-up ; it divides the day in two and starts you off 
all fresh again. 

If you have time left over, spend it in quiet 
pleasures, at least for the first months. Out-of- 
door recreation is much more beneficial than in- 
door. If you are strong enough, a garden will fur- 
nish interesting work from the time the snow 
leaves the ground in the spring until it begins to 
fall again in the winter. More than walking and 
some other things, it gives you something to think 
about and plan for. For those who are fond of 



AND HOW TO PROTECT IT. 6l 

plants and flowers it might mean a great deal to 
keep a garden. A very small plot of ground will 
furnish occupation for many spare minutes each 
day. There are digging, raking and fertilizing to 
do, seeds to be put in, and later on weeding and 
watering to be attended to. It is a healthy pleas- 
ure that keeps you out of doors. For those who 
are more interested in other out-of-door things 
there are many to choose from — bird study, bot- 
any, photography, driving, fishing, mineralogy. 
Select the one that appeals to you most, and the 
more you pursue it, the more irresistible it be- 
comes. You will find yourself daily getting so 
much more cure in an enjoyable way. 

But if you find that you are a little tired after 
your day's work, and that these things require too 
much energy — don't you do them, for there is plenty 
else to do that is both interesting and helpful. If 
you have a veranda and chair, stretch out and rest, 
or if not make yourself comfortable in a well- 
ventilated room. Take out your books and relax 
in them. You can forget all your troubles in good 
books. Quiet games with good friends may be 
indulged in. Avoid games that are long and ex- 
citing. Dances, meaning, as they generally do, 
late hours, excitement and getting overheated, are 
especially risky. Severer forms of exercise, golf- 
ing, rowing, paddling, ought only to be done on 
the physician's advice; otherwise you may do 
yourself incalculable harm. 

If you fall ill, whether it is a hard cold, a cough, 
or tonsilitis, do not disregard, but be proportion- 
ately more careful than other people who have no 



62 THE WORKING PEOPLE: THEIR HEALTH 

tuberculosis. These things may mean a serious 
setback if allowed to drag* on. If possible, stay 
away from work for a day or two, and carefully 
nurse the illness away at the start. Little things 
mean so much when you first go home. Avoid 
exposure of all kinds, and do not run unnecessary 
risks. Above all, do not let yourself get tired out 
or exhausted; if you start each morning tired out, 
you are probably overdoing. 

If it is possible, a person will gain a great deal 
by making a holiday time of his week ends, 
especially after a particularly trying week's work. 
If you can get clean away from stores and houses 
and streets, out into the country, no matter 
whether it is flat or rolling, and have a whole day 
or day and a half out of doors, it will rest you in- 
finitely. 

A cheerful spirit will do wonders, too; don't think 
too much of what to do to keep well, but just do it 
as unconsciously as possible and go on with an easy 
conscience. Brooding and worry hold many peo- 
ple back more than anything else. It is generally 
essential on going back to keep in touch with a 
physician, and in choosing one be sure to select a 
reliable man and one who understands tuberculo- 
sis and the modern treatment of it. If he says 
you have no trouble, laughs at your being careful 
and says you can do anything you like, go a little 
farther and look up a wiser doctor. Let him 
study your case from the beginning, and enter into 
partnership with him towards the keeping of your 
health. Then when a real worry comes along you 
have a trained man to lean on; bring it to him 



AND HOW TO PROTECT IT. 63 

and leave it with him, or at least let him lighten 
it. There will be many difficult places that he can 
help you over, uncertainties as to whether you are 
holding your own, advice about vacation, exercise, 
minor ailments, as colds, indigestion, etc. 

There are often trials of another sort on going 
home. If you still have a cough and expectora- 
tion, people may be afraid of you. Some people 
have a superstitious fear of tuberculosis, think it 
contagious, like smallpox or scarlet fever. But 
wiser people will not feel this way, and if you are 
careful you will not be uncomfortable. Do not 
forget the rules you have learned in the sanita- 
rium — be absolutely conscientious about the care 
of expectoration, if you have any. Use squares of 
cheesecloth, or a pocket cup, as these may be kept 
inconspicuously in a rubber-lined pocket or rub- 
ber-lined bag and carefully burned. The rubber 
lining can be cleaned with a five per cent, carbolic 
solution. Always cover your mouth when you 
cough. Wash your hands often and clean your 
teeth several times a day. Control your cough. 
It is best to have a room of your own, but if this 
is not possible, have a single bed. 

Try to be regular about your meals and to en- 
joy them all you can. Relax utterly, forget about 
your work for a little while and converse cheer- 
fully. If you can do this, you will have done a 
great deal towards making digestion easy, and 
consequently get more out of your food. If possi- 
ble, don't eat when you are tired; lie down and 
rest first, even if it is only for a few minutes. Eat 
slowly, chew your food well, and if you can, rest 



64 THE WORKING PEOPLE: THEIR HEALTH 

for a while after meals. For the maintenance of 
good nutrition, to have wholesome, nourishing 
food is a very important matter. Do not over- 
feed or eat too much of the more bulky food-stuffs, 
but try to select things that are both appetizing 
and nourishing, especially good beef, lamb, good 
butter, milk and eggs, good bread, milk puddings, 
plenty of vegetables and fruit. 

Many people in good condition will find that 
they hold their weight, without forced feeding, on 
a generous mixed diet; allowance should be made 
for some loss which usually comes with harden- 
ing. As long as you keep above your old weight 
in health, worry is unnecessary. But if there is 
loss continually week after week, and you are 
going below your old normal, try some extra nour- 
ishment, as eggs and cream, or a change of board- 
ing-house if you board. If these fail, take a 
week's holiday and get out into the country, or 
away somewhere for a change. You cannot afford 
to let loss of weight continue, especially if it is 
associated with fatigue or any of the old symp- 
toms, as fever, night sweats, or loss of appetite. 

Use common sense with regard to your clothes. 
If most of your day is spent indoors, dress for in- 
doors, and put on extra wraps when you go out 
For underwear, wool and linen mesh are good. 
Use a lighter weight in the summer than in the 
winter. Be very careful about changing your 
clothes in the fall and the spring. Don't get over- 
heated if you can help it. It is in this way that 
many colds are contracted. If you do get over- 
heated, try to change your clothes and rub dry. 



AND HOW TO PROTECT IT. 65 

Don , t give up your daily cold sponge bath or 
cold bath. Remember it is one of the things that 
will help to keep you well; it is both hardening 
and tonic. A warm bath should be taken at bed- 
time once or twice a week. The observance of all 
the little things give you by just so much a better 
chance. 

When you get back to the old surroundings, 
you must try in every way to get plenty of fresh 
air to breathe — fresh air in your office, in your 
house and everywhere possible. If you can man- 
age it, live in the suburbs rather than in the city, 
and in the country rather than in the suburbs. 
The farther out you get the purer the air is ; it cir- 
culates more freely, and is less laden with smoke, 
dust and gases of manufacture. Try to form the 
habit of ventilating your house and office. 

If such a luxury is possible, a veranda will mean 
a great deal towards keeping well, and especially a 
second floor veranda, because this is so much 
more private. Make it just as comfortable and 
attractive as you can, with bed or chair, rugs, 
Jight, table, book-rest — everything to entice you 
out both by night and by day. To a person who 
has to work indoors during the day the opportunity 
to sleep out at night is all-important, and means 
so many hours spent out of doors each day. If 
this is not possible, try to have a room with plenty 
of window-space which can be well ventilated and 
kept fresh all night. The roof can often be util- 
ized when porches, etc., are not possible. A shel- 
ter built on the roof makes a very good place to 
rest or sleep in out of doors. 



66 THE WORKING PEOPLE: THEIR HEALTH 

To sum up briefly, remember in a good many 
cases that your remaining well depends largely on 
yourself. If you put your mind to it and perse- 
vere in doing all that you know is best, you will 
get your reward. You have only to think of what 
has been impressed on you all the time of your 
stay at the sanitarium. The three great things 
are rest, good food and fresh air. I put them in 
this order purposely, although they are in most 
ways equally important. But if any should stand 
first for the convalescent, it is rest, to keep always 
within the fatigue limit. Then comes good food 
and the maintenance of a healthy, hard body 
weight, and third comes fresh air. With most 
people, too, cheerfulness is as necessary as any of 
these — to enjoy your work, your home, your food 
and exercise, that is, to derive almost double the 
benefit out of each of them. Be hopeful and see 
the bright side. Never worry, but use the energy 
this would lose for you in trying to get out of your 
difficulty. Plug along and do the best you know, 
and after that just trust. The cheerful have a long 
start of the worriers when it comes to getting well. 
Even though you have to deny yourself much, you 
will find plenty of compensations. To quote from 
Stevenson's "Child Verse:" 

"The world is so full of a number of things, 
I am sure we should all be as happy as kings." 



AND HOW TO PROTECT IT. 67 



CHAPTER XI 
Prevention of the Spread of Tuberculosis 

Massachusetts was the first State in the Union 
to establish a State board of health, which it did 
in 1869. It was the first State to build a sanato- 
rium for incipient cases of tuberculosis and the 
first State to erect hospitals for advanced cases. 

Below, with its permission, I have incorporated 
in this work its excellent circular on tuberculosis, 
and I would advise a careful study of the same, as 
it contains many valuable suggestions: — 

"The prevalence of tuberculosis can be dimin- 
ished by knowledge on the part of the people of 
the nature of the disease, and a general applica- 
tion of the principles underlying its prevention 
and cure. 

"Tuberculosis is a disease which spreads from 
one person to another by germs which gain an 
entrance to the body generally through the nose 
or mouth into the lungs, sometimes through the 
mouth into the stomach and intestines, and rarely 
through the skin. The germs get into the air 
mainly from the spit of persons who are suffering 
with tuberculosis of the lungs. If one member of 
a family has tuberculosis and does not use care to 
burn or destroy all spit, this spit dries and be- 



68 THE WORKING PEOPLE : THEIR HEALTH 

comes a part of the small bits of dust in the air 
which the other members of the family breathe. 
In this way brothers and sisters and others in the 
household may take the disease. In the same way 
the lives of many people are in constant danger in 
the hotel, the workshop, the library or the railroad 
car. 

"Another way in which germs get into the air is 
with the particles that fly out from the mouth or 
nose when persons who have tuberculosis of the 
lungs neglect to hold a piece of cloth in front of the 
mouth or nose every time they cough or sneeze. 

"Because of these ways in which germs get into 
the air, it has been found necessary to teach per- 
sons who are suffering with tuberculosis how to 
prevent giving the disease to others, and to teach 
well persons how to protect themselves and chil- 
dren from the careless or ignorant patients. The 
following instance shows the importance of keep- 
ing young children away from persons who are 
suffering with tuberculosis of the lungs: 

"Two little girls were much in the room and 
about the bed of a young woman who was suffer- 
ing from tuberculosis of the lungs, although this 
was not discovered until later. Within three 
months of that time and within six weeks of each 
other both died of tuberculosis. 

"Still another though very rare way in which 
germs may enter the body is with milk from tuber- 
culous women. Likewise, germs may enter the 
body with milk from tuberculous cows and with 
meat from tuberculous animals. 



AND HOW TO PROTECT IT. 69 

PUBLIC HEALTH 

I. How the State Protects the Individual, and What 
Individuals Should do to Protect Each Other 

A . The Powers and Duties of the State Board of Health and 
the State Inspectors of Health 

"1. The State Board of Health has for some 
time been making a careful inspection of dairies 
and slaughter-houses, in the interest of public 
health. Milk from unknown sources, or from 
herds not regularly inspected, should not be given 
raw to infants or children. Cooking meat and 
heating milk in a closed vessel for twenty minutes 
or longer at or above 140 F. destroys any germs 
present. One especial object of the dairy inspec- 
tion is to exclude milk from public sale which 
comes from tuberculous cows, because tuberculo- 
sis is occasionally transmitted by cows' milk to 
human beings. The occasional infection coming 
from milk leads to swelling of the glands of the 
neck and to abdominal tuberculosis, but not to 
tuberculosis of the lungs. 

"2. The State Inspectors of Health are required 
to gather all information possible concerning the 
prevalence of tuberculosis and to take such steps 
as after consultation with the State Board of 
Health and the local health authorities shall be 
deemed necessary for the protection of the public. 
If any citizen, therefore, knows of a person suffer- 
ing with tuberculosis who is not receiving proper 
care, or who, through carelessness and neglect, is 
endangering others, it is clearly his duty to notify 
the State Inspector of Health within his district. 



Jo THE WORKING PEOPLE: THEIR HEALTH 

By so doing the patient himself will receive the 
best possible care, and the health of others will be 
properly guarded. 

"3. The State Inspectors of Health are further 
required to inform themselves concerning the san- 
itation and ventilation of factories and workshops 
in their respective districts, to enforce certain laws 
relative to the same, and to inform themselves 
concerning the health of all minors in such estab- 
lishments. Whenever the family history discloses 
illness or death of any member due to> tuberculo- 
sis, the State Inspector of Health makes a physical 
examination of that minor; and in every instance, 
whether or not a physical examination is made, a 
concise report is submitted to the State Board of 
Health on the immediate sanitary conditions 
under which the minor works, apart from the gen- 
eral report which covers details relative to the 
lighting, ventilation and cleanliness of the entire 
factory. 

"Private individuals, physicians, social service 
workers and organizations of various kinds may 
be of great assistance to the State Inspectors of 
Health by calling to their attention any known un- 
sanitary conditions, diseases or influences danger- 
ous to the public health or threatening to affect 
the same. Instances like the following should be 
reported immediately to the State Inspectors of 
Health. A young woman who was working in a 
candy establishment came to a dispensary of an 
anti-tuberculosis society for examination. She 
was coughing and spitting. An arrangement was 
made for her to enter a sanatorium, where she 



AND HOW TO PROTECT IT. 71 

could receive the best care, and be taught how to 
help herself and to protect the health of others. 

"4. The law requiring that every public building 
and every schoolhouse shall be adequately venti- 
lated is to be enforced by the State Inspectors of 
Health, so that medical inspectors of schools and 
teachers should notify them of any violation of this 
law. Notice of any ill-ventilated or overcrowded 
schoolhouse should be brought to the attention of 
the State Inspector of Health in whose district the 
schoolhouse is located. 

"5. It is particularly desirable that the tenement 
and dwelling houses, and shops where persons 
work on clothing, shall be kept clean, and that the 
State Inspectors of Health be notified of any in- 
fectious or contagious disease present, so that, if 
an unhealthy condition is found, such orders may 
be issued as the public safety requires. 

"6. Suitable receptacles for spitting must be 
provided in all factories and workshops, and one 
of the duties of the State Inspectors of Health is 
to notify the local boards of health and the State 
Board of Health of any failure to comply with this 
requirement. 

"7. Spitting is prohibited, under a penalty of not 
more than $20, in or upon any part of any mill or 
factory and in certain public places and convey- 
ances, as follows : upon any public sidewalk or 
upon any place used exclusively or principally by 
pedestrians, or, except in receptacles provided for 
the purpose, in or upon any part of any city or 
town hall, any court house or court room, any 
public library or museum, any church or theatre, 



J2 THE WORKING PEOPLE: THEIR HEALTH 

any lecture or music hall, any mill or factory, any 
hall of any tenement building occupied by five or 
more families; any school building, any ferryboat 
or steamboat, any railroad car except a smoking- 
car, any elevated railroad car except a smoking- 
car, any street railway car, any railroad or railway 
station or waiting room, or any track, platform or 
sidewalk connected therewith, and included within 
the limits thereof. The statute provisions permit 
arrest without a warrant. 

B. The Duties of Householders, Physicians and Local 
Health Authorities 

"i. If a householder knows that a person in his 
family is sick with tuberculosis, he is expected to 
notify at once the board of health of the city or 
town in which he lives. 2. If a physician knows 
that a person whom he is called to visit has tuber- 
culosis, he must give immediate notice to the 
board of health. 3. If the board of health has 
had notice of a case of tuberculosis, it is required 
to notify the State Board of Health without delay, 
giving the name and the location of the patient. 

C. Instruction in the Public Schools and Medical Inspection 
of School Children 

"1. In accordance with a law passed in March, 
1908, special instruction as to tuberculosis and its 
prevention must be given, as a regular branch of 
study in connection with the subject of physiology 
and hygiene, to all pupils in all schools which are 
supported wholly or partly by public money, ex- 




MARIE LOUISE ROCHELEAU 



FIRST PATIENT TO BE CURED OF TUBERCULOSIS UNDER 
MANUFACTURERS AND MERCHANTS' AGREEMENT 



AND HOW TO PROTECT IT. 73 

cept schools which are maintained solely for in- 
struction in particular branches. 

"2. State laws provide for the examination and 
diagnosis, by school physicians, of children attend- 
ing the public schools. Whenever a child shows 
symptoms of tuberculosis, he shall be sent home 
and the board of health shall at once be notified. 
Notice of any child, known, to be attending school, 
who shows signs of being in ill health or of suffer- 
ing from infectious or contagious disease, may be 
brought to the attention of the State Inspector of 
Health in whose district the schoolhouse is located. 

D. State Sanatoria for Persons III with Tuberculosis 

"1. The Massachusetts State Sanatorium at Rut- 
land, the first State institution of its kind in this 
country, provides for the treatment of persons ill 
with tuberculosis within the Commonwealth. The 
trustees and overseers of the sanatorium are war- 
ranted in giving preference to incipient cases. The 
sanatorium has no proper accommodations for 
children, so that persons under fourteen years of 
age are not admitted. 

"2. The Legislature of 1907 provided for the con- 
struction of three new sanatoria for the treatment 
of persons ill with tuberculosis. Following are the 
sites for the buildings: (1) at North Reading, in 
northeastern Massachusetts; (2) at Lakeville, in 
southeastern Massachusetts ; and (3) at Westfield, 
near the West Springfield line, in the Connecticut 
valley. Notice of any person needing to be cared 
for in such hospitals may be brought to the atten- 



74 THE WORKING PEOPLE : THEIR HEALTH 

tion of the State Inspector of Health in whose dis- 
trict the person lives. 



II. How Heads of Families and Householders May Pre- 
vent Members of the Household from 
Taking the Disease 

"i. Whenever a member of a household is sick 
with tuberculosis, have the other members, espe- 
cially the children, examined. Meanwhile, keep 
young children away from the patient and from 
the room or rooms in which the patient stays. Al- 
low no nurse or caretaker who has tuberculosis of 
the lungs to be employed about the children. 

"2. The bed-rooms are, so far as health is con- 
cerned, the most important rooms in the house. 
Here children spend about half their lives. These 
rooms should be kept clean and well aired. The 
windows should be opened wide several times a 
day. If possible, sunny rooms should be used for 
bed-rooms, and the windows kept partly open at 
night to ensure a plentiful supply of fresh air. 

"3. The patient's bed linen and underclothing 
should be boiled, and the blankets hung out of 
doors on every sunny day. 

"4. Because of danger from drinking cups and 
other dishes, you should either provide a separate 
set of dishes for the patient, or require the greatest 
care to be taken to boil all those which he has 
used. 

"5. Carefully clean and disinfect all rooms which 
you are to occupy where persons with tuberculosis 
have been housed. Rooms should be made as bare 



AND HOW TO PROTECT IT. 75 

as possible of furnishings which cannot be easily 
cleaned. Handling dirty and soiled carpets im- 
parts danger to others. Carpets should be damp- 
ened before removing them, and all dust should be 
kept moist. Walls and all woodwork, including 
floors, should be scrubbed with a hot solution of 
washing soda. Ceilings should be re-whitened and 
walls re-papered and painted. 

"6. Do not occupy immediately a house in which 
tuberculous persons have been living, without first 
cleaning and properly disinfecting the house or 
such parts thereof as have been frequented by the 
sick. The germs probably do not live after six 
months, and some of them will be destroyed before 
that time. 

III. How the Individual Patient May Prevent Members 

of his Family and Other Persons 

from Taking Tuberculosis 

"1. When indoors, or in closed cars or vehicles, 
hold a piece of cloth in front of your mouth or 
nose every time you cough or sneeze. What you 
cough up may contain germs which will endanger 
others if inhaled or swallowed. 

"2. Use a spit cup which can be properly cleaned, 
or paper spit cups, paper napkins or some other 
receptacle which can be destroyed with its con- 
tents by burning. 

"3. When you have used a paper napkin either 
to spit in or to wipe your mouth with, fold it care- 
fully and put it into a paper bag which you are 
to carry with you. Destroy the bag with its con- 
tents at your earliest opportunity. 



ye THE WORKING PEOPLE : THEIR HEALTH 

"4. Do not let any spit get on your clothing or 
on anything about you, wherever you may be. 

"5. Always clean your hands before handling 
food substances of any kind. The following case 
illustrates a very common danger: A woman of 
forty-five years had been ill with tuberculosis for 
eighteen months. Recently one of her three daugh- 
ters, aged fifteen, was seized with the same disease. 
During one of her violent coughing spells the 
mother shielded her mouth with her right hand. 
Immediately upon stopping she went to the pan- 
try, put her right arm into a bag of apples, took 
out three apples, polished each of them with her 
right hand, then passed one to each of her three chil- 
dren, who eagerly ate of the fruit. Not long after- 
ward the oldest daughter was found to have the 
disease throughout her body, and later died at a 
hospital to which she and her mother were sent. 

"6. Never kiss an infant or a young child. Grown 
persons may be kissed on the cheek, but not on 
the lips. 

"7. Use great care not to come in contact with 
young children. This is especially necessary when 
an infant is brought up in a family where the dis- 
ease prevails. 

"8. Sleep alone, and, if possible, in a room by 
yourself. 

"9. If a mother, you must not nurse your child. 

IV. How Employers May Guard the Health of their 
Employees 

"1. Factories and workshops should be well ven- 
tilated and not overcrowded. Persons who work 



AND HOW TO PROTECT IT. JJ 

day after day in rooms which are impossible of 
ventilation may after a time lose weight and 
strength and become ill with tuberculosis. This 
is especially true of a workshop where many people 
work side by side, some of whom may at the time 
be suffering with tuberculosis of the lungs. One 
of the most important duties of an employer is to 
provide fresh air for his employees. 

"2. Suitable receptacles for spitting should be 
provided in all factories and workshops, the num- 
ber and kind depending upon various factors; e.g., 
the nature of the industry, the cleanliness of the 
establishment, the employees, etc. — conditions to 
be determined by the local board of health in the 
town or city where the factory is located. If metal 
receptacles are furnished, they should be half filled 
with water, or, better, should contain one per cent, 
carbolic acid, or some chlorinated lime, to prevent 
flies eating the spit. They should be emptied fre- 
quently into some place where the spit can pos- 
itively do no harm, and should then be scrubbed 
with boiling or hot water containing a little car- 
bonate of soda (washing soda). If such precau- 
tions are not taken, the spit dries, and the dried 
particles containing germs of tuberculosis float 
about in the air. Flies may carry the germs of 
tuberculosis if allowed to feed on spit. Should 
these germs get into the body, tuberculosis may 
result. On the other hand, the destruction of spit 
prevents one great means of the spread of the dis- 
ease, 



78 THE WORKING PEOPLE : THEIR HEALTH 

PERSONAL HEALTH AND HABITS 
I. Suggestions to Patients 

"i. All nose and throat troubles, a cough which 
lias lasted for some time, a continued flushed face 
or fever, or the first indication of mouth breathing, 
should lead you to seek medical aid. 

"2. Insist upon plenty of fresh air in the sleeping 
room. Have your bed in that part of the room 
which is exposed to an abundance of air. 

"3. Open the windows in all the living rooms 
often. Let in the sunlight. 

"4. Stay out of doors whenever you can. A 
balcony may be fitted up both for sitting and sleep- 
ing purposes. Children should live as much as pos- 
sible in the open air, and every form of sport en- 
couraged which tends to keep them there. A per- 
son who is ill with tuberculosis must be where he 
can be kept in the open air for at least several 
hours each day, in spite of fever or cough, although 
it is important that he shall be kept warm while 
in the open air. Sudden, unnecessary exposure to 
extreme changes in the weather should be avoided. 
When a patient is confined to bed, the largest, best- 
ventilated and sunniest room should be used, and 
a window should be open most of the time. 

"5. Wear light underwear of moderate weight, 
and put on outside wraps according to changes in 
the weather. Light underwear is cheaper and bet- 
ter. 

"6. Bathe your neck and chest, front and back, 
with cold water each morning. Rub the skin well 



AND HOW TO PROTECT IT. 79 

with a coarse towel. The skin should be red after 
the bath. 

"7. Spend your money for good food rather than 
for medicines. Patent medicines, or proprietary 
preparations, or drugs of any kind, should not be 
taken internally without the advice or consent of 
a physician in good standing. 

"8. Avoid fatigue. If you are working, lie down 
when you have a few moments to spare. 

"9. Remember that many persons who have suf- 
fered with tuberculosis are now well, and that the 
disease is no longer regarded as incurable. 

"10. If you are so ill that you cannot recover, 
you can gain much comfort by protecting the 
health of those who are near and dear to you. 



II. Suggestions to the Public 

"1. Well persons who persist in spitting- in places 
prohibited by law should not forget that some of 
the persons who are sick with tuberculosis will see 
them spit and pattern after them, and in this way 
endanger the lives of others. It is important to 
acquire clean personal habits, both for the purpose 
of protecting one's self and others. 

"2. Every one who has a cough should make an 
effort to cough as little as possible. By so doing 
he helps himself and greatly lessens the risk of 
making others ilL 

"3. It is not at all uncommon to-day to hear of 
instances where the very means of obtaining one's 
livelihood has been taken away because the per- 



80 THE WORKING PEOPLE: THEIR HEALTH 

son was unfortunate enough to have tuberculosis. 
To take away from such a person the means of 
obtaining his livelihood is to take it from the very- 
person who needs it most. 

"It should be remembered that a person ill with 
tuberculosis, whose personal habits are clean and 
who takes care of the material which he coughs up, 
is a safe person to live with, and that he may at- 
tend to his work without endangering his fellow 
workmen. Failure to appreciate this fact is al- 
ready causing many hardships, which are both un- 
necessary and unjust." 

NAMES OF THE STATE INSPECTORS OF HEALTH 

Health District No. i. — Dr. Charles E. Morse, 
Wareham. 

Health District No. 2. — Dr. Adam S. MacKnight, 
Fall River. 

Health District No. 3.— Dr. Wallace C. Keith, 
Brockton. 

Health District No. 4. — Dr. Elliott Washburn, 
Taunton. 

Health District No. 5. — Dr. Harry Linenthal, Bos- 
ton. 

Health District No. 6. — Dr. Albert P. Norris, Cam- 
bridge. 

Health District No. 7. — Dr. J. William Voss, Bev- 
erly. 

Health District No. 8.— -Dr. William Hall Coon, 
Lawrence. 

Health District No. p. — Dr. Charles E. Simpson, 
Lowell. 



AND HOW TO PROTECT IT. 8l 

Health District No. io.—Dv. William W. Walcott, 

Natick. 

Health District No. n. — Dr. Melvin G. Overlook, 

Worcester. 

Health District No. 12. — Dr. Lewis Fish, Fitchburg. 

Health District No. 13. — Dr. Harvey T. Shores, 

Northampton. 

Health District No. 14. — Dr. Herbert C. Emerson, 

Springfield. 

Health District No. 15. — Dr. Lyman A. Jones, North 

Adams. 



82 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XII 

Dangers of Overwork 

The human body is simply a machine having 
forty-two hundred parts; it is the only machine 
that oils itself. The pump, or heart, in twenty- 
four hours exerts a force that would lift sixty-three 
gallons of water to the top of Bunker Hill Monu- 
ment. Man's endurance is greater than that of a 
horse, and his body has a power of resistance which 
is simply wonderful. However, this self-same ma- 
chine soon rebels against rough usage and so-called 
overwork, whether it be mental or physical, and 
when a crash comes, no matter how skillfully re- 
paired, that body is never the same. Serious ill- 
ness, brought on by overwork, always leaves the 
system in a condition more ready to be invaded 
by disease. Therefore, all men and women 
should guard carefully against putting themselves 
into a position where they must be told that they 
are "all run down/' But you are going to say to 
me, "How can I help it? This work must be done 
or I must lose my place;" or if it be a mother she 
will say, "I cannot sit down; I cannot lie down." 
To you I want to point out by simply taking fifteen 
minutes in the afternoon and fifteen minutes in the 
forenoon, if more time cannot be spared, to give 
yourself up to perfect relaxation in the seven days 



AND HOW TO PROTECT IT. 83 

upon which you say you must work, you have 
gained two hundred and ten minutes — three and 
one-half hours. Such time is worth more to you 
than one whole day's rest each week. 

A complete relaxation of the human body when 
it is tired, if only for a brief period of time, has a 
tonic effect upon your whole system. 

How long is it going to be before men and 
women learn that there is only just so much in 
their bodies? It is not the distance, but the pace 
that kills. At fifty you should be in the prime 
of life, yet how many men and women can 
boast of this? How many look from the hospital 
bed and say, "Oh, if I had only taken more rest, 
if I had only been more careful I should never be 
in a position where, when I asked the doctor what 
he honestly thought of my case, he politely told 
me that I had no reserve strength, no reserve 
power." 

You should act as your own conservation com- 
missioner; you cannot burn the candle at both ends. 
To you women and girls who are overworking and 
are cognizant of the fact, I want to say to you that 
at the age of forty years you approach the critical 
point in your existence. It is for you to say 
whether you arrive there broken down, your nerves 
and muscles in ho condition to stand the strain 
thrown upon you at that time; or whether you 
reach that age with a body full of strength and 
vigor, prepared to fight the menapause (or change 
of life). You know that statistics bear out the 
fact that at this age our asylums and sanitariums 
place most of their cases on record. You tell me 



84 THE WORKING PEOPLE: THEIR HEALTH 

that this is all theory. I have tried in this book to 
avoid theory and dwell only on cold, hard facts, 
borne out by statistics, and this holds good in this 
chapter. Study yourself; you know what you can 
and cannot stand. By standing I do not mean that 
you should only stop working when you are will- 
ing to collapse. If you are the mother of a large 
family, don't think that you must sit up and work 
on Mary's dress until ten o'clock at night and then 
only stop when you are nearing collapse. Per- 
haps the child in the cradle looks to you for its 
nourishment and supper, and becomes a weakling 
because his mother gets too tired. 

Not to overwork is a duty you owe to your hus- 
band, your children and to yourself. Of what good 
are you to your family after you are broken down? 
You cannot even enjoy your home. The most piti- 
ful spectacle I have ever seen is a mother sur- 
rounded by plenty, too> nervous to tolerate even her 
husband's voice — one whose health has departed 
and who, by reason of her surroundings, must 
endure the noise of little children whose innocent 
babble would under other circumstances be pleas- 
ant to hear. 

The danger of overwork lies in not taking rest 
at stated intervals. Lie down after the mid-day 
meal, and relax yourself for thirty minutes at least. 
One of the best preserved women I ever saw is a 
patient of mine who all through her life has taken 
certain periods of rest every day of her life. She 
is a mother of three strong, healthy children. If 
you are unmarried the same principle holds true. 
Rest at stated intervals. Never mind a broken en- 



AND HOW TO PROTECT IT. 85 

gagement to meet some friend ; she will enjoy your 
company so much better when you are rested, and 
soon will begin to ask you why you are looking so 
well. Eat right, bathe right, sleep right, care prop- 
erly for the body and the teeth. Use your head 
many times instead of your hands, and when you 
reach the age of fourscore years and ten, you will 
look with pity upon those who wasted their lives 
because of overwork. 



86 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XIII 
Walking and its Relation to Health 

As a nation, Americans ride too much and walk 
too little. Walking is one of the very best exer- 
cises. Why? First, because it keeps one in the 
open air; second, because it gives ample oppor- 
tunity to take lung baths and pulmonary gymnas- 
tics, thus enriching the blood and building up every 
tissue of the body. It makes a most perfect exer- 
cise for the muscles of the thigh, legs and back; 
the demand on the nerve control is small; the in- 
fluence on the pulse and blood pressure and respi- 
ration is only moderate. It cultivates endurance, 
and the best age in which it may be practiced is 
from fifteen to sixty-five years; the gait should be 
from two to four miles an hour. 

English women are great walkers and they are 
noted for their erect carriage and power of en- 
durance. The man who works all day at his desk 
in an office, and then stands for twenty minutes 
waiting for a street car is not only losing valuable 
time, but forming a habit hard to break. The same 
is true of women who follow a clerical life. Closed 
up, as it were, for seven or eight hours a day, they 
come out upon the street, wait ten or fifteen min- 
utes, sometimes longer, for a car and then get into 



AND HOW TO PROTECT IT. 87 

a poorly ventilated vehicle, with thirty or forty 
other people, and breathe a vitiated atmosphere for 
the next half hour — an atmosphere many times 
contaminated by germs of different kinds. The 
muscles, which all day have been inactive, are still 
kept at rest when they should be having proper 
exercise. Walking four miles a day, walking right, 
will do much to build up not only the muscular 
but the nervous system as well. In walking, one 
should walk properly if one would get the 
most out of it and be benefited thereby. Stand 
erect, lift the head from the chest, throw back the 
shoulders, and at the same time cultivate an easy 
swinging stride ; keep the mouth closed, and breathe 
entirely through the nose. As you are walking, 
easily fill the lungs with fresh air, and then exhale 
slowly. 

A physician, a friend of mine, who was troubled 
with bronchitis and asthma, gave up riding either 
in the cars or in his carriage and followed out the 
rules laid down above. Within one year he in- 
creased the expansion of his chest more than three 
inches and had gotten rid of his asthma and bron- 
chitis; built up his muscular system and rid him- 
self of his nervousness. 

Walks taken in the early morning before break- 
fast have a tendency to increase the appetite and 
to relieve constipation. Yes, as a nation we walk 
too little, thereby losing the opportunity many 
times of breathing fresh air which carries oxygen 
to all the tissues of the body. 

In writing this chapter I cannot be called a fad- 
dist, for the testimony of those who have made it 



88 THE WORKING PEOPLE : THEIR HEALTH 

a point to walk a good deal all through life bear 
testimony to its value. 

One other point in walking and then I will leave 
the subject for your trial and careful considera- 
tion: There are in the apex or upper portion of 
the lungs, a large number of unused cells which 
are never brought into play and do not contribute 
towards carrying oxygen to the body. By walking 
and breathing properly these lung cells will be 
developed, thereby giving you more breathing 
space, also a well-developed chest. I can point out 
to you many hale and hearty old men and women 
and you will invariably find that they have been 
addicted to the habit of walking all their lives. 



AND HOW TO PROTECT IT. 89 



CHAPTER XIV 

Prevention of Disease Among Those who 
Follow Different Occupations 

In this chapter, in a work of this size, I can 
touch but lightly upon the question of preventing 
disease among those in various occupations. The 
occupations which I have selected are the ones in 
which consumption occurs most frequently. I shall 
outline a few salient points that appear to me to 
be important in the prevention of this disease. 

PRINTERS 

I have selected this class and occupation first, 
not because the mortality is highest among print- 
ers, but because recently 203 printers working in 
different offices volunteered to take a physical ex- 
amination, which was made by Dr. Miller of New 
York. One hundred and forty-nine, or nearly three- 
fourths, were born in the United States ; the major- 
ity of the others were either English or Scotch ; one 
hundred thirty-seven were married, and as to age, 
forty-eight were between 20 and 30; eighty-nine 
between 30 and 40; fifty between 40 and 50; six- 
teen between 50 and 60. 

Present physical condition: Thirty-one per cent, 
were found to be normal. Catarrh of the upper 



90 THE WORKING PEOPLE: THEIR HEALTH 

air passages was found in 57 cases; chronic phar- 
yngitis, 14; chronic rhino pharyngitis (these last two 
being disease of the mucous membrane of the nose 
and throat) and chronic rhinitis, 22 (this is a disease of 
the mucous membrane of the nose) ; chronic laryn- 
gitis, 1; hypertrophied tonsils, 5; adenoids, 2; bron- 
chitis, 11; pulmonary emphysema, 8; pleurisy, 33; 
pulmonary tuberculosis, 34. The result of this ex- 
amination tends to show that consumption is very 
frequent among printers; that printers are very 
subject to catarrh ; that disturbance of digestion is 
frequent and probably plays an important part in 
determining the health of the trade. Irregular 
habits of living in general, among printers, are a 
contributing cause, as is the use of alcohol. Be- 
coming rapidly chilled by open windows and then 
running out of doors, is responsible for many sud- 
den colds that predispose to catarrhal diseases. A 
few simple rules strictly adhered to would go a 
long way towards warding off many of the troubles 
found to exist. 

First, avoidance of alcohol; second, bolting food 
and a longer period for lunch; attention to the 
nostrils by the use of a douche used before and 
after the day's work ; attention to the bowels, avoid- 
ing constipation always. Nearly every State now 
has laws looking towards proper ventilation of 
printing offices. Be careful about your sputum and 
see that those around do the same ; open your win- 
dows when in bed, either through the day or night ; 
follow the system of exercises for breathing laid 
down in this work, which are simple; eat plain, 
easily digestible food; pay especial attention to 



AND HOW TO PROTECT IT. 91 

bathing. Leave cigarettes alone; avoid excesses in 
all things, and the high mortality which exists at 
the present time among those who follow this most 
honorable calling will be materially reduced. 

Since beginning this chapter I have learned that 
the National Typographical Union is perfecting 
plans looking towards the establishment of a san- 
itarium for incipient tuberculosis among its mem- 
bers. This of course is a great step forward, and 
as it is the leader in this great work, I trust that 
other organizations will soon follow its example. 



DANGER TO GRINDERS AND POLISHERS 

It is unnecessary for me to say to you that your 
occupation places you in a position where there is 
a constant inhalation of fine dust. This irritates 
the throat and small tubes known as bronchial 
tubes, causing the mucous membrane to be sensi- 
tive and easily inflamed. You know, also, that al- 
though State laws, in nearly every State, protect 
you by forcing manufacturers to provide hoods and 
suction pipe for all who work on buffing, yet there 
are other preventive measures that might be em- 
ployed by you, as, for instance, a sponge properly 
cut and shaped to the nose and coming down over 
the mouth should be worn. This kept moist could 
be worn without much inconvenience. Then there 
is a little shield made to fit the nostrils, which lasts 
for a long time, that may be worn which will pre- 
vent a large portion of the dust from being inhaled. 
There are simple preventive measures which you 



92 THE WORKING PEOPLE: THEIR HEALTH 

can easily follow; in addition to this, you should 
take care of the nose and throat. A simple douche 
for the nose with a Sieler's tablet, morning and 
night, will keep the nose and throat in a healthy 
condition. Another important thing, and perhaps 
the most important, is the care of the stomach and 
bowels. The avoidance of fast eating, the care of 
the teeth, the watching for an overcrowded condi- 
tion of the stomach, all tend to keeping the mucous 
membrane of the nose and throat in a healthy con- 
dition. Many people only have sore throat and 
catarrh when they have disordered digestion. Es- 
pecial attention to the proper amount of fresh air 
in your sleeping-room tends to build up your re- 
sisting power against disease. Asthma is often 
caused by an over-accumulation of acid in the 
system. 

STONE AND MARBLE CUTTERS 

The mortality from consumption and pneumonia 
in your trades is high, and as I watch you work 
and inhale dust, I do not wonder that it is so. I 
find very few making any attempt at all to shield 
the nose and throat from the particles of fine dust 
while at work. Some of you wear a sponge fitted 
to the nose, but most of you wear nothing at all. 
A simple arrangement made with a piece of wire 
for a frame, the nose covered with a piece of cheese- 
cloth, inside of which a piece of absorbent cotton 
is placed, would do much towards arresting the 
dust which finds its way first into the nasal pas- 
sages and then into the throat and bronchial tubes, 



AND HOW TO PROTECT IT. 93 

and in many cases into the lungs. Fine particles of 
dust are often found in the lung when an autopsy 
is made. Look to your general health; avoid in- 
temperance in both eating and drinking, and pay 
especial attention to the bathing. Keep the mouth 
clean, remove all decayed teeth as soon as found; 
do not neglect a cold. If you find yourself getting 
tired take a few days' absolute relaxation. Take 
regular breathing exercise as outlined in the chap- 
ter on breathing in this book, and you will stand a 
much better chance of escaping not only tuber- 
culosis, but pneumonia and other diseases of the 
throat and lungs to which your occupation pre- 
disposes. 

WEAVERS 

Our industrial civilization has produced a large 
army of weavers, not only in this country, but in 
all countries, and history has shown that wherever 
you find people engaged in this occupation you find 
consumption. Why is this so? First, because in 
the past many of the factories were poorly venti^ 
lated, usually overheated; that the removal of dust 
was inefficient. In many instances there were con- 
ditions over which the operative had no control 
and the operatives themselves have been careless 
in many ways : first, because they excluded fresh air 
from the room in which they worked, and, second, 
because they slept with windows closed; third, be- 
cause they failed to take lung baths and did not pay 
particular attention to the care of the body, where 
exercise and bathing were concerned. 



94 THE WORKING PEOPLE : THEIR HEALTH 

Now that laws are in force in most states for the 
removal of dust, for pure drinking water, seats for 
women, proper ventilation, proper toilets, proper 
light, you should keep well. If you would main- 
tain your health follow these rules : 

First: Eat to moderation; don't overload your 
stomach; don't bolt your food; do not drink with 
your meals. Second : Keep your mouth and teeth 
clean; sleep with windows open; keep in open air 
as much as possible; avoid alcoholic stimulants; 
avoid patent medicines; take plenty of time for 
rest. Young girls, avoid the dance hall, particu- 
larly after n p.m. Learn to breathe properly, to 
take proper and systematic exercise ; make the best 
of your surroundings, let the sunlight into your 
home, spend your money for fruits rather than can- 
dies. Keep the feet dry, particularly at your 
monthly periods. 

For men : Don't bundle the chest, but keep feet 
dry; select the places you are to live in with care 
and then keep them clean and sweet; remember 
that sunlight and fresh air are the two great foes 
of disease. If you follow this chapter closely you 
will be surprised at the change brought about in 
your physical condition, even in the short period of 
one year, and none of the things asked of you are 
impossible or hardships. 

In conclusion, I desire to say to all factory work- 
ers : Don't be afraid of fresh air ; let it into your 
workroom; let it into your homes. Pay especial 
attention to your stomach ; avoid eating cheap can- 
dies; avoid patent medicines; avoid worry; avoid 
late hours. The present system of long hours will 



AND HOW TO PROTECT IT. 95 

soon be changed, everything pertaining to the san- 
itation of the workshop, factory and store is rap- 
idly undergoing a change for the better, and as fast 
as your employer makes changes for bettering your 
condition while at work, take the lessons of sani- 
tation home with you and see that they are applied 
in your home as well as in your factory. 



96 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XV 

How to Live a Hundred Years 

Against diseases known, the strongest fence 
19 the defensive virtue, abstinence. 

— Benjamin Franklin. 

"If any man can convince me and bring home to 
me that I do not think or act arigiht, gladly will I 
change; for I search after truth, by which man 
never yet was harmed. But he is harmed who 
abideth on still in his deception and ignorance. 

"Do not think that what is hard for thee to mas- 
ter is impossible for man ; but if a thing is possible 
and proper to man, deem it attainable by thee. 

"Persevere, then, until thou shalt have made 
these things thine own. 

"Like a mariner who has doubled the promon- 
tory, thou wilt find calm, everything stable, and a 
waveless bay. 

"Divine sobriety, pleasing to God, the friend of 
nature, the daughter of reason, the sister of virtue, 
the companion of temperate living; modest, agree- 
able, contented with little, orderly and refined in 
all her operations ! From her, as from a root, 
spring life, health, cheerfulness, industry, studious- 
ness, and alt those actions which are worthy of a 
true and noble soul. From her presence flee, as so 



AND HOW TO PROTECT IT. 97 

many clouds from the sunshine, reveling, disorders, 
gluttony, excessive humors, indispositions, fevers, 
pain, and the dangers of death. Her beauty at- 
tracts every noble mind. Her security promises to 
all her followers a graceful and enduring life." 

Louis Cornaro, a great Venetian sanitarian, said, 
on reaching his ninety-fifth year: "I find myself, 
in spite of my great age, healthy, strong, con- 
tented and happy; and that I continually praise the 
Divine Majesty for so much favor conferred upon 
me. Moreover, in the generality of other old men 
whom I see, no sooner have they arrived at the age 
of seventy than they are ailing and devoid of 
strength; melancholy; and continually occupied 
with the thought of death. They fear, from day to 
day, that their last hour will come; so much so, 
that it is impossible for anything to relieve their 
minds of that dread. For my part, I do not ex- 
perience the least trouble at the idea of death; for 
as I shall later on explain more clearly, I cannot 
bring myself to give it so much as a thought." 

He further says: "Health in the body is like 
peace in the state and serenity in the air. Health 
is the soul that animates all enjoyments of life, 
which fade and are tasteless, if not dead, without 
it. A man starves at the best and the greatest 
tables, and is poor and wretched in the midst of 
the greatest treasures and fortunes. With common 
diseases, strength grows decrepit; youth loses all 
vigor, and beauty all charms; music grows harsh, 
and conversation disagreeable; palaces are prisons, 
or of equal confinement; riches are useless; honor 
and attendance are cumbersome; and crowns them- 



98 THE WORKING PEOPLE : THEIR HEALTH 

selves are a burden. The vigor of the mind de- 
cays with that of the body, and not only humor and 
invention, but even judgment and resolution 
change and languish with ill constitution of body 
and of health; and, by this means, public business 
comes to suffer by private infirmities, and king- 
doms or states fall into weaknesses and distempers 
or decays of those persons that manage them. I 
have seen the counsels of a noble country grow 
bold or timorous, according to the fits of his good 
or ill health that managed them; and the pulse of 
the government beat high and low with that of the 
governor. Thus, accidents of health grow to be 
accidents of state; and public constitutions come 
to depend, in a great measure, upon those of par- 
ticular men. 

"Health and long life are usually blessings of the 
poor, not of the rich ; and the fruits of temperance, 
rather than of luxury and excess. And, indeed, if a 
rich man does not, in many things, live like a poor 
man, he will certainly be the worse for his riches; 
if he does not use exercise, which is but voluntary 
labor; if he does not restrain appetite by choice, as 
the other does by necessity ; if he does not practice 
sometimes even abstinence and fasting, which is the 
last extreme of want and poverty. If his cares and 
his troubles increase with his riches, or his pas- 
sions with his pleasures, he will certainly impair 
in health whilst he improves his fortunes, and lose 
more than he gains by the bargain; since health is 
the best of all human possessions, and without 
which the rest are not relished or kindly enjoyed." 



AND HOW TO PROTECT IT. 99 

Samuel Johnson says: "Health is, indeed, so 
necessary to all the duties as well as pleasures of 
life, that the crime of squandering it is equal to the 
folly; and he that for a short gratification brings 
weakness and diseases upon himself, and for the 
pleasure of a few years passed in the tumults of 
diversion and clamors of merriment condemns the 
maturer and more experienced part of his life to 
the chamber and couch, may be justly reproached, 
not only as a spendthrift of his happiness, but as 
a robber of the public; as a wretch that has vol- 
untarily disqualified himself for the business of his 
station, and refused that part which Providence as- 
signs him in the general task of human nature." 

The words of Cornaro, given above, were written 
in the middle of the fifteenth century. It will be 
noted that the writer was born a weakling, yet at 
forty years he determined to live to be a hundred. 
How well he succeeded is proven by the fact that 
he lived to be 102 years of age and then passed 
away like one falling asleep. The one thing that 
people advanced in years will not consider, is that 
a man's once a man and twice a child. As we 
begin to age in point of years all our muscles age; 
the stomach, which is a muscle, grows weaker in 
its action, it digests your food by a churning mo- 
tion, and by the movement of one coat upon the 
other, and depends upon the elastic condition of the 
stomach cells for its power as a digestive organ. 

As you reach the noonday of your life and begin 
the descent of the hill on the downward grade, if 
you would reach the bottom, which means ripe old 
age, you must at once begin to be careful, lest you 



100 THE WORKING PEOPLE : THEIR HEALTH 

slip and fall by the wayside. You will ask me 
this question, "How shall I live?" Naturally 
enough you expect me to answer this question. 

First of all, then, you must avoid dissipation in 
both eating and drinking, and dissipation after fifty 
years applies in many ways. Don't think because 
you have always eaten everything, as you say, that 
you can continue to do so ; don't think because you 
have been in the habit of remaining up until eleven 
o'clock that you can still continue. If you do you 
are burning the candle at both ends. When some- 
one tells you, "Oh, go ahead, do the same as you 
always did and use a little stimulant," this is all 
wrong and only shortens your life. 

Diet in old age is the keynote to the whole sit- 
uation. Like a baby you do not need the food you 
used to take, you cannot take care of it, you will 
not digest it; you will only clog the stomach and 
bowels with food that has not been digested. This 
means repeated attacks of indigestion and bilious- 
ness, which after fifty or sixty are both weakening 
and dangerous. Reason with yourself; don't have a 
horror of growing old, for if you grow old right, you 
have many pleasures in store for you. Live right 
so that you may be an example to your children 
and grandchildren. Be proud of the remarks, "you 
are a hale and hearty old man or woman," "as 
bright as a button," and as active mentally as you 
ever were. Pay the same attention to bathing, to 
breathing, to sleeping and to exercise that you did 
in your youth, and you will be surprised to find 
the change it will bring about in your physical 
being. Of course, the exercise must be graduated, 



AND HOW TO PROTECT IT. IOI 

to suit your declining years. Time after time you 
will hear the expression, "There is no fool like an 
old fool;" that means that after you reach the age 
of sixty, you often do the very things which you 
know hurt you. This is particularly true of eat- 
ing, drinking and sleeping. Again, by the time you 
have reached the ages of fifty or fifty-five, that old 
axiom, "Know thyself," must be put into action. 
Remember one thing: you cannot eat, sleep, keep 
late hours, subject yourself to the mental and phys- 
ical strain that you did when you were younger. 
Take fifteen minutes each day and give it up to 
intelligent thought about the care of your bodily 
health and you will be surprised to learn how much 
you can gain in so doing. Reason with yourself 
and allow yourself to be reasoned with. 

Every few months have your physician look you 
over, examine your urine, give you a little pains- 
taking advice, which you should closely follow. 
Live for others as well as for yourself; remember 
that you are not the last of your race. If you are 
blessed abundantly with this world's goods, spend 
a portion of it in carrying light and sunshine into 
some home darkened by misfortune and poverty: 
Try in your declining years to do your part in lift- 
ing up the fallen, don't crowd your fellow men, be 
charitable to those who err. Remember that the 
young woman of to-day is surrounded by an en- 
tirely different atmosphere from that of your girl- 
hood, that the young man is beset by temptation 
which in your time did not exist. Cultivate a 
cheerful disposition and make the best of your 
surroundings ; read books pertaining to health mat- 



102 THE WORKING PEOPLE : THEIR HEALTH 

ters, look on the sunny side always, and in the end 
you will be blessed as was Louis Cornaro, away 
back in the fifteenth century, with a blessed and 
happy old age, and when you pass away leave foot- 
prints on the sands of time that will be eagerly 
sought by those who follow you. 



AND HOW TO PROTECT IT. 103 



CHAPTER XVI 
Conservation of the Nation's Health 

People have got to learn to be their own doctors 
as far as the care and protection of their health 
are concerned. Each family must learn to eat and 
drink properly, ventilate their homes, breathe and 
dress properly, — in general to give more intelligent 
and careful thought to these essential conditions 
that are so necessary to keep the tone of their bod- 
ies in good condition, so as to be able to resist the 
germs of disease that attack them. This should be 
done if we would help to relieve ourselves and all 
others from dreaded disease. Who can be so un- 
patriotic, indifferent or unintelligent as not to be 
willing to make such self-denials as are necessary? 

From the lowest form of life to man, the essential 
conditions of life and health have been few and 
plain. Through all the ages of that slow ascent, 
but with varying emphasis, these have been: food, 
air, sunshine and exercise. Upon a supply of these 
in proper kinds and amount, depends the health of 
every man, woman and child in the universe. 

Hospitals, sanitariums, class-teaching and clinics 
are small schools in which hygiene is taught. At 
the present time this teaching is the most potent, 
in fact the only course which is given strictly re- 



104 THE WORKING PEOPLE : THEIR HEALTH 

lating to health matters. Our medical colleges of 
to-day teach how to cure disease, but are neglect- 
ing the most important branch, that of preventive 
medicine and personal hygiene. A ray of sunshine, 
however, appears on the horizon when we are told 
that three universities have adopted courses in per- 
sonal hygiene and preventive medicine. 

The time is fast approaching when in our indus- 
trial centres, state and municipal functions will 
provide living-quarters which will allow you to 
maintain your physical health. 

Today, in many instances, it is certain that the 
earning capacity of our wage-earners and the pur- 
chasing power of their earnings are weakened by 
unsuitable housing. While most landlords are con- 
siderate and humane, yet there are too many who 
care not how their tenants exist, providing they pay 
their rent. It is for this class of property holders 
legislation is needed. Those of you who must live 
in this class of houses are in no position to resist. 
I believe the time is not far distant when a min- 
imum condition will be established which will be 
legal for light and air-space per capita, with proper 
toilet accommodations. 

New York, to her glory, has a law applying not 
only to new houses in process of construction, but 
for the inspection of those already occupied. The 
landlord protects himself against the loss of rent; 
you must be protected against the loss of your 
health. 

When our physicians are better educated in san- 
itation; when your pastor takes an interest in your 
home surroundings; when the present awakened 



AND HOW TO PROTECT IT. 105 

conscience begins to speak to the people through 
your best friend, the public press, — then those 
whom you send to the Legislature and the Congress 
to make your laws will become interested in your 
welfare, as they should be. It will become your 
duty then, even more than now, to fulfill your part 
of your most solemn obligation — duty to yourself 
and to those around you by making use of the 
knowledge being imparted to you relative to your 
personal and bodily health. But while you are 
waiting for this to take place remember that con- 
sumption is rampant, and only comparatively few 
who contract it can now gain admission to a sani- 
tarium. Therefore, make the best of your surround- 
ings. 

Like a mighty wave sweeping over our country, 
today the great question of a better national health 
is surging. The press is heralding truth and scien- 
tific knowledge; the public is following in line. 
Wise State laws willingly lived up to in our manu- 
facturing and commercial institutions are fast mak- 
ing for better health conditions everywhere. 



io6 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XVII 

The Working Day 

The present working day, from a physiological 
standpoint, is too long, and keeps the majority of 
bread-winners in a continual state of over-fatigue. 
It starts a vicious circle, leading to the craving of 
means for deadening fatigue, thus inducing drunk- 
enness and other excesses. Experiments in short- 
ening the working day show a great improvement 
in the physical efficiency of laborers, and in many 
cases result in even increasing their output suffi- 
ciently to compensate the employer for the shorter 
day. Several examples of such a result exist, but 
the real justification for a shorter work day is in 
the interest of the race. One company, which keeps 
its factory going night and day, found, on chang- 
ing from two shifts of twelve hours each to three 
shifts of eight hours each, that the efficiency of the 
men gradually increased, and the days lost per 
man by illness fell from seven and one-half to five 
and one-half per year. Public safety requires, in 
order to avoid railway collisions and other acci- 
dents, the prevention of long hours, lack of sleep, 
and undue fatigue in workmen. 



AND HOW TO PROTECT IT. 107 

THE IMPORTANCE OF PREVENTING UNDUE FATIGUE 

The economic waste from undue fatigue is prob- 
ably much greater than the waste from serious ill- 
ness. This is because the number of fatigued per- 
sons is great enough to more than outweigh the 
fact that the incapacitation from fatigue is rela- 
tively small. Moreover, the relatively slight im- 
pairment of efficiency due to over-fatigue leads to 
greater impairment from serious illness. A typical 
succession of events is, first, fatigue, then "colds," 
then tuberculosis, then death. The prevention of 
undue fatigue means the arrest at the start of this 
accelerating chain of calamities. 

The Solvay Process Company, of Syracuse, in- 
stalled in 1892 a system of three eight-hour shifts 
in place of the two previous shifts of eleven and 
thirteen hours, respectively. It was stated by the 
assistant general manager, in 1905, that the change 
had considerably lessened the wear and tear on the 
men, and that they could be called on to do their 
work at their highest state of efficiency, which had 
not been possible on the two-shift basis. President 
Hazard of the company writes : — 

"In general, I can say that the results of the change from 
a twelve-hour shift to an eight-hour shift were very satis- 
factory and have continued to be so. While the immediate 
result was to increase considerably the cost per unit of 
product, the efficiency of the men gradually increased, so 
that at the end of about one year, the first increase has 
been overcome, and the cost per unit of product fell to a 
point even lower than had been obtained under the twelve- 
hour shift, and further, the time consumed per unit of 
product has since been so reduced that we are to-day, and 



108 THE WORKING PEOPLE : THEIR HEALTH 

for some time have been, operating with a smaller number 
of hours per unit of product than we had under the twelve- 
hour shift." 

Further proof of the benefits of the change to the 
three-shift day is furnished by the records of the 
Solvay Mutual Benefit Association for 1891 and 
1904. The days lost per man by sickness each 
year fell from seven and one-half days in 1891 to 
five and one-half days in 1904. 



AND HOW TO PROTECT IT. 109 



CHAPTER XVIII 

Hygiene 

state hygiene 

The regulation of the labor of women and chil- 
dren is usually a state matter. It has been sug- 
gested by Dr. Stiles that every woman should be 
allowed once a month to leave a factory without 
being asked questions or losing wages. The em- 
ployment of mothers before and after childbirth 
should be prohibited, as it is now in a number of 
European countries. This single reform would help 
greatly to conserve the vitality of the next genera- 
tion. Child labor in the South is in many cases 
the lesser of two evils ; the other being exposure to 
the hook-worm disease on polluted farms. In these 
cases the abolition of child labor should be pre- 
ceded by the abolition of hook-worm disease. 
Hours of labor have been steadily decreasing, and 
should be decreased further. Accidents are unneces- 
sarily frequent on our American railroads, as well 
as in industrial establishments. Statistics do not 
exist for the latter. Special trades have special 
dangers. Among such trades are those using lead 
and other dangerous poisonous chemicals, as well 
as the dust-producing trades, which tend to pul- 
monary troubles. The dark room tenements are a 



IIO THE WORKING PEOPLE: THEIR HEALTH 

common means in our large cities of depleting na- 
tional vitality. 

FEDERAL HYGIENE 

This includes quarantine, the inspection of immi- 
grants, and exclusion of those with infectious dis- 
eases, administration of government hospitals, of 
pure-food laws and meat inspection, and coopera- 
tion with State boards of health in fighting yellow 
fever, bubonic plague, etc. Federal power needs 
extension, however. Our interstate railroads should 
be improved in respect to the sanitation of sleep- 
ing-cars, smoking-cars, etc. 

The movement to secure a more intelligent na- 
tional organization of health has found expression 
in the platforms of both political parties. What is 
needed is that the Federal Government should 
make the national capital a model of sanitation, 
should provide for more investigation in health 
matters and the dissemination of information on 
the prevention of tuberculosis, etc., should cooper- 
ate further with state and municipal authorities, 
and should check the pollution of interstate streams 
and prevent the transmission of disease-bearing 
meats, or other food, from one State to another. 
Lastly, it should secure, through whatever consti- 
tutional means exist, some method of collecting 
statistical information as to our national mortality 
and morbidity. Our shortcomings in this respect 
are now a national disgrace. There is no accurate 
record of births in any part of the United States, 
and that of deaths includes less than half our pop- 



AND HOW TO PROTECT IT. in 

ulation. As a statistician has said of one of the 
states, "It buries its dead people with no more 
ceremony than it buries its dead dogs." Obviously, 
no intelligent control of epidemics and other dis- 
eases can be secured unless the facts in regard to 
those diseases are known; in other words, unless 
there exist mortality and morbidity statistics of 
real value. 

SEMI-PUBLIC HYGIENE, MEDICAL RESEARCH AND 
INSTRUCTION 

Semi-public hygiene comprises that relating to 
institutions and the medical profession. The hy- 
giene of the future must depend more on discov- 
eries in preventive medicine than on any other 
single factor, and institutions, such as the Pasteur 
Institute, the Rockefeller and Carnegie institutes, 
and the research laboratories of the government 
and universities offer the most promising means 
of increasing this most useful and practical of all 
human knowledge. The knowledge is dispensed 
through medical schools in the training of physi- 
cians. These schools are improving so as to intro- 
duce more of hygiene and preventive medicine. We 
are still far, however, from having facilities for 
training public health officers, or giving them such 
a degree as D.P.H. (diploma of public health), as 
is given in England. 

The efficiency of Japanese hygiene was shown in 
the fact that General Oku's army of 75,000, during 
the recent Russo-Japanese war, had but 187 ty- 
phoid fever cases in a seven months' active cam- 



112 THE WORKING PEOPLE: THEIR HEALTH 

paign. The Japanese reduced their dysentery cases 
from 112,052 in the Chinese war to 6624 in the 
Russian war; their cholera cases from j66j to 
none; and their malaria cases from 41,734 to 1257. 
This in spite of the fact that their army in the 
Russian war was three times the size of that em- 
ployed in the Chinese war. 

As to exercise, a healthy organism must call into 
play every function daily, both mental and physi- 
cal. One of the evils of the division of labor which 
civilization has brought is that the sedentary 
worker does not have enough physical exercise, but 
too much mental exercise; while the situation is 
just the opposite in the case of the workingman. 

A well-known physical director, now nearly 50 
years old, writes me that he has this year taken up 
systematic physical training, which he has neg- 
lected for several years because of pressure of 
work. As a result, his weight has risen, his chest 
and arm girths have increased, while his waist 
girth has decreased, and he is conscious of decided 
improvement in memory and in sleep. This in- 
stance is cited as an example of the physical devel- 
opment possible in a man of middle age. 

In its bearing on exercise, the growth of modern 
athletics and its effects on the physical ideals of 
men and women are to be welcomed. The revival 
of the Olympian games and the spread of popular 
participation in such outdoor sports as golf, tennis, 
boating and horse-back riding have all had their 
share in building up a new health ideal. Thus we 
are getting away from the mediaeval idea of morti- 
fication of the flesh and approaching more closely 



AND HOW TO PROTECT IT. 113 

the Greek conception of a beautiful body as the 
covering for a beautiful soul. The Greeks lifted 
their sports to a higher level than ours by surround- 
ing them with imagination and making them a 
training in aesthetics as well as in physical excel- 
lence. The American idea is at present too closely 
connected with mere winning, and not enough with 
development. In the past the physical athlete has 
been too much associated with the pugilist, and has 
been looked down upon as having merely brute 
strength. The intellectual type, on the other hand, 
has been content wholly to neglect bodily develop- 
ment. 

In the last three years considerable evidence has 
accumulated to show that the sitting posture of the 
sedentary man tends, sooner or later, to produce 
nervous prostration, and that the ordinary chair 
invites to this effect by producing a bent attitude, 
both in the forward direction and in the shoulders. 
The effect of the former is to tax the splanchnic 
nerves and congest the portal circulation. The 
splanchnic area, which is enormous, is a sort of 
overflow tank for the blood. If the muscles of this 
area are allowed to relax through improper position 
in standing or sitting, the result is the stagnation of 
the blood in the abdomen, and this in turn results 
in a vicious circle of evil effects. Since much of 
our life is spent in chairs, this fact is of no small 
importance. Improperly made school chairs and 
unhygienic habits of sitting in them may start off 
millions of young lives with round shoulders, 
curved spines, and the later effects of portal con- 
gestion. 
8 



114 THE WORKING PEOPLE: THEIR HEALTH 

Exercise of mind does not simply mean exercise 
of intellect. The emotions and the will are equally 
a part of a well-developed, healthy man. Late in 
life Darwin had occasion to lament the fact that 
his emotional capacity had become cramped be- 
cause he had exercised his mind in his own branch 
of work to the exclusion of other things. Whatever 
our ideas of theology or religion are, it is true that 
we all ought to have a spiritual sense. Some men 
lack this spiritual sense and are incapable of under- 
standing the spiritual experience of others. "For 
toil without purposeful and occupied leisure is un- 
filled purpose, a process arrested midway." Worry 
and fear are unhealthy. Hope, courage, enjoyment, 
and an optimistic attitude generally, are healthy. 

The ordinary workingman works two or three 
hours too much every day. Nearly every man 
overworks himself, takes insufficient rest and rec- 
reation, and worst of all, cuts off his normal por- 
tion of sleep. Fatigue ought to be "avoided like 
poison," because, physiologically, it is really poi- 
son. Worry, fear and anger also produce poisons 
harmful to the human body. This is suggested at 
least by the effect upon a nursing infant of violent 
paroxysms of anger, or periods of intense fear or 
anxiety on the part of its mother. The intense 
exhaustion which iollows such paroxysms is an- 
other case in point. 

An animal lives a much more healthy life than 
the average man, because an animal follows in- 
stinct, while a man, to a large extent, endeavors to 
substitute for his instincts rules which are very 
often false. One of the instincts constantly dis- 



AND HOW TO PROTECT IT. 115 

regarded by man is that which finds its expression 
in fatigue. The ordinary man working for some 
one else is compelled to toil beyond the fatigue 
limit; and, on the other hand, if a man is in bus- 
iness for himself, he does the same thing of his 
own will. Although no one knows what sleep is, 
it serves, according to the best theory, to eliminate 
poisons and to rebuild tissue. With rest is closely 
associated recreation. Play practices the power of 
a child's mind, while contact among children de- 
velops self-control. Similarly, adults are rested by 
play or recreation, their minds and bodies are re- 
laxed, while their contests of mimic warfare de- 
velop their powers of will and effort. 

THE LENGTH OF LIFE VERSUS MORTALITY 

By those who have never considered the prob- 
lem, death and disease are accepted as a matter of 
course. In individual cases it is recognized that a 
death or an illness might have been prevented, but 
the idea that the death rate could be changed in an 
appreciable degree, or controlled, is quite foreign 
to the mind of the average man. Charles Babbage 
wrote : "There are few things less subject to fluc- 
tuation than the average duration of life of a mul- 
titude of individuals." 

If this statement were correct, we should find the 
average duration of life and the death rate sub- 
stantially the same in different places and at differ- 
ent times. The facts do not conform to this view. 
Modern life tables show that the average length 
of life in the leading countries of the world varies 
remarkably, as the following figures will illustrate : 



Males. 


females. 


50-9 


53-6 


50.2 


53-2 


457 


49.1 


44.1 


477 


44.1 


46.6 


42.8 


43-1 


41.0 


44-5 


23.0 


24.0 



116 THE WORKING PEOPLE: THEIR HEALTH 

MODERN DURATION OF LIFE 

Country. 

Sweden, 1891-1900, 

Denmark, 1895-1900, 

France, 1898- 1903, 

England and Wales, 1891-1900, 

United States (Massachusetts), 1893- 1897, 

Italy, 1899- 1902, 

Prussia, 1891-1900, 

India, 1901, 

When we consider that the average duration of 
life in India is scarcely more than one-half that of 
France and less than one-half that of Sweden, we 
must conclude that the length of human life is de- 
pendent on definite conditions and can be increased 
or diminished by a modification of those conditions. 

AVERAGE DURATION OF LIFE AT DIFFERENT PERIODS 

Striking corroboration of this conclusion is found 
as soon as we compare the average duration of life 
at different periods of time. The earliest attempt to 
discover a law of human mortality appears to be 
that of Ulpian, a Roman praetorian prefect, about 
220 A. D. The meaning of his table is somewhat 
doubtful, but it is assumed to refer to "expectation 
of life," which for ages up to 20 is given as thirty 
years. This estimate is so crude and vague as to 
be of little value for comparative purposes. Pro- 
fessor Finkelnburg, of Bonn, estimates that the 
average length of human life in the sixteenth cen- 
tury was only between eighteen and twenty years, 
and that at the close of the eighteenth century it 



AND HOW TO PROTECT IT. 117 

was a little over thirty years, while today it is 
between thirty-eight and forty years. 

In Geneva the records go back over three cen- 
turies, showing the following life span : 

16th century, 21.2 

17th century, 25.7 

1 8th century, 33.6 

1801-1883, 397 

Here we see an increase in the span of life of 
100 per cent, in three or four centuries. The last 
few decades, moreover, tell a striking story of in- 
crease. It is one of the boasts of the nineteenth 
century that the splendid medical and scientific ad- 
vances of that period have aided in a distinct 
lengthening of life. 

In 1693 the British Government borrowed money 
by selling annuities, and in 1790, a century later, 
it did the same thing. While the first venture 
proved satisfactory, the second caused a great loss 
to the government, owing to the improvement in 
longevity, which had taken place, and which was 
estimated, for the annuitant class, at 20 years. 

If we compare Ogle's English life tables for 1871- 
1881 with those of Farr for 1838-1854, we find an 
increase in life span of 1.4 years for males and 2.8 
for females. A still greater improvement has been 
effected since Ogle's figures of 1871-1881 : 

Lifetime in England and Wales: 

Males— 

1838-1854, 39.9 

1891-1900, 44.1 



Il8 THE WORKING PEOPLE: THEIR HEALTH 



Females — 




1838-1854, 


41.8 


1891-1900, 


47.8 


Similar improvements 


are observable in 


countries. 




Lifetime in France: 




Males — 




1817-1831, 


38.3 


1898-1903, 


45-7 


Females — 




1817-1831, 


40.8 


1898-1903, 


49.1 


Lifetime in Prussia: 




Males— 




1867-1877, 


35-3 


1891-1900, 


41.1 


Females — 




1867-1877, 


37-9 


1891-1900, 


44.6 


Lifetime in Denmark: 




Males— 




1835-1844, 


44-6 


1895- 1900, 


50.2 


Females — 




1835-1844, 


44-7 


1 895- 1 900, 


53-2 


Lifetime in Sweden: 




Males — 




1816-1840, 


39-5 


1891-1900, 


50.9 


Females — 




1816-1840, 


43-5 


1891-1900, 


53.6 



other 



It is difficult to obtain American life tables that 
go far enough back into history to display increases 
in the life span similar to those just presented; yet 



AND HOW TO PROTECT IT. 119 

comparisons of Abbott's Massachusetts life tables 
for 1893-1897 with Elliott's Massachusetts tables 
for 1855, and Wigglesworth's Massachusetts and 
New Hampshire life tables of a century ago, give 
us a progressive increase from 35 in 1789 to 40 in 
1855, and 45 in 1893-1897. Unfortunately no tables 
exist for the United States as a whole from which 
similar comparisons might be made. Good and re- 
liable vital statistics are among our most crying 
needs. Meech's life tables, based on the census 
figures of 1830, 1840, 1850 and i860, showed a 
life span, for the whole country, of 42. 

The census of 1880 gave some 70 sets of life 
tables for different registration states and cities. 
The expectation of life for white males was given 
for Massachusetts as 44, New Jersey 46, District of 
Columbia 41, and New York city 33 ; but in con- 
structing the tables "the census was too prodigal 
as to quantity and somewhat careless as to quality. 
It is difficult to separate the wheat from the chaff. 
The table should have been accompanied by a run- 
ning criticism. The general defect was that no 
attempt was made to correct the deficiencies in the 
returns for infants." The census for 1890 gives 
only a few life tables, and that for 1900 none. 

In striking contrast to these recent increases of 
the life span in progressive countries is the table 
for backward India, which showed no advance in 
twenty years: 

Lifetime in India: 
Males — 

1881, 23.7 

1901, 23.6 



120 THE WORKING PEOPLE : THEIR HEALTH 
MORTALITY IN VARIOUS REGIONS 

Forty years ago the variations in the death rates 
of the different sections of Europe were given, by 
Quetelet, as follows: 

DEATH RATE PER IOOO OF POPULATION 

Northern Europe, 24.3 

Central Europe, 24.5 

Southern Europe, 29.7 

Today the death rates of various countries com- 
pare with each other, as in the following table: 

MODERN DEATH RATES PER IOOO OF POPULATION 

Denmark (1906), 13-5 

Sweden (1906), 144 

England and Wales (1906), 15.4 

United States (registration area, 1907), 16.5 

Germany (1905), 19.8 

France (1906), 29.8 

Italy (1906), 20.8 

Japan (1905), 21.9 

India (males, 1901), 42.3 

As we have found in the study of duration of life, 
so we find here wide variations from country to 
country. Italy presents a death rate larger by 
nearly one-sixth than that of the United States, 
while famine-tortured and plague-ridden India's 
mortality rate is twice that of France and three 
times the rates of Denmark and of Sweden. Even 
the fairly homogeneous population of our registra- 
tion states in America shows variations in death 
rates as follows : 



AND HOW TO PROTECT IT. I2 i 

DEATH RATE PER IOOO OF POPULATION IN IOXKD 

Michigan, 13.9 

Vermont, 17.0 

Massachusetts, 17.7 

New York, 17.9 

The death rate in Michigan, at the one extreme, 
is thus but three-fourths that of New York, at the 
other extreme. This difference may probably be 
accounted for in part by the difference in the age 
constitution, as the population of Michigan con- 
tains a larger proportion in young and vigorous 
life than New York. 

Comparison of urban and rural death rates also 
give us variations : 

URBAN AND RURAL MORTALITY DEATH RATE PER 

IOOO OF POPULATION IN I90O 

Massachusetts : 

Urban, 17.9 

Rural, 17.1 

Michigan : 

Urban, 15.3 

Rural, 13.3 

New Jersey: 

Urban, 18.8 

Rural, 15.5 

Interesting comparisons may be made of the 
death rates of American cities varying in size and 
location. The death rate per iooo of population, in 
1906, was given as 14.2 (probably incorrect) in 
Chicago, in Boston 18.9, in New York 18.6, and in 
Philadelphia 19.3. Cleveland, Ohio, was credited 



122 THE WORKING PEOPLE : THEIR HEALTH 

with a death rate of but 16, while Cincinnati, in the 
same State, had 20.8. The causes of such differ- 
ences are not always attributable to variations in 
size. New Haven, for instance, a larger Connecti- 
cut city than either Hartford or New London, had 
a lower death rate in 1900 by 2.2 and 2.5, respect- 
ively, per 1000 population. The differences are ac- 
counted for partly by differences in age, constitu- 
tion, partly — it is unfortunately true — by differences 
in the accuracy of the collected statistics; partly 
by differences in size and location, and partly by 
differences in the vigilance of the public and private 
health authorities. 

European cities show even greater variations in 
mortality than these just given for the United 
States. 

DEATH RATES OF EUROPEAN CITIES PER IOOO 
POPULATION (1897) 

Locality. High. Locality. Low. 

Dublin, 39.9 Frankfort-on-the-Main, 15.6 

Moscow, 36.9 The Hague, 16.2 

Belfast, 31.3 Berlin, 17 

St. Petersburg, 31 Amsterdam, 17.8 

RACE AND CONDITION 

The variations in death rates among different 
races are well known. The black race, for example, 
always suffers a higher mortality than the white. 
In Boston, during the half century from 1725 to 
1774, the death rate per 1000 is given as ranging 
from 56 to 87 for the blacks and only from 30 to 



AND HOW TO PROTECT IT. 123 

41 for the whites. Thus the maximum white death 
rate was lower than the minimum black death rate. 
In 1906 the death rate per 1000 in all registration 
cities having not less than 10 per cent, colored in- 
habitants was 17.2 for whites and 28.1 for blacks. 
These racial differences may be ascribed in part to 
different habits and conditions in life, but probably 
in part, also, to varying racial susceptibility to dis- 
ease. 

The relation of social status to the rate of mor- 
tality has been often discussed and offers a partial 
explanation of racial or national variation of death 
rate. That a well-to-do class, properly fed and 
clothed, and with opportunity for leisure, will be 
less susceptible to disease and death than a pov- 
erty-stricken class, ill-fed and overworked, has been 
repeatedly shown by statistics. Newsholme has 
shown, for example, that in Glasgow the death rate 
among tenants of large houses is much lower than 
among the tenants of smaller dwellings: 

One and two Three and Five 

room houses, four room rooms 

houses, and over. 

Death rate per 1000 occupants 
in 1885, 27.7 19.5 1 1.2 

In Paris comparison has been made between two 
quarters known to be rich, on the one hand, and, 
on the other, a third quarter known to be poor: 

DEATH RATE PER IOOO POPULATION 

Rich quarters: 

Elysee, 13.4 

Opera, 16.2 

Poor quarter: 

Menilmontant, 31.3 



124 THE WORKING PEOPLE: THEIR HEALTH 

In Russia a similar comparison has been made 
between peasants who own no land, those who own 
less than 13J acres, those who own between 13 \ 
and 4oJ acres, and so on up the scale of proprietor- 
ship. The tables for one province follow: 

PRESENT DEATH RATE PER IOOO, GOVERNMENT OF 
VORONEZH (1889-1891) 

Class of Household. Per 1000. 

Having no land, 34.7 

Having less than 13.5 acres, 32.7 

Having 13.5 and less than 40.5 acres, 30.1 

Having 40.5 and less than 67.5 acres, 25.4 

Having 67.5 and less than 135 acres, 23.1 

Having more than 135 acres. 19.2 

Occupational comparisons are often made; and 
while they must be handled with great care, espe- 
cially because of differences in age, the following 
may be said to display roughly the variations in 
death rate among social classes : 

DEATH RATE OF MALES PER IOOO, ACCORDING TO 

OCCUPATIONS, FOR REGISTRATION 

STATES, I9OO 

Mercantile and trading, 12. 1 

Clerical and official, 13.5 

Professional, 15.3 

Laboring and servant, 20.2 

Finally, the experience of industrial life-insurance 
companies, which deal largely with the poorer 
classes of society, shows a higher death rate than 



Ordinary Insurance, 
English Experience. 


Industrial Insurance. 
Metropolitan Life. 


7-3 


10.5 


7-8 


14. 1 


9-3 


17.2 


21.7 


35-2 


649 


91.0 



AND HOW TO PROTECT IT. 125 

that displayed by the experience tables of other 
insurance companies. 

INSURANCE MORTALITY PER IOOO 

Age. 
20 

25 

35 
55 
70 

We find, also, great variations in death rates de- 
pendent on varying climatic or seasonal conditions, 
on the prevalence or absence of certain pests, on 
the fluctuating virulence of specific diseases, and 
on numerous natural differences. Other significant 
factors in mortality are historical events, such as 
wars, plagues and epidemics. Hard times bring 
increased mortality, whether due to natural or 
politico-economic causes. There remain to be men- 
tioned, also, deaths by accident in all its many 
forms. 

MORTALITY HISTORICALLY 

Not only does the death rate vary greatly from 
place to place and from one social class to another, 
but it changes in a most marked fashion from 
period to period in history. The records of old 
cities show that a decided decrease in mortality has 
been steadily going on. In London, for example, 
the rate per 1000 has fallen from 50 in 1660-1679 
to 15 in 1905, a decrease of 70 per cent. In the 
plague years, 1593, 1625, 1636 and 1665, the death 



126 THE WORKING PEOPLE: THEIR HEALTH 

rates per iooo were 240, 310, 130, and 430. The 
"black death" in 1348-9 probably swept away half 
of the population in manv localities throughout 
Europe. 

Within a quarter century London has cut her 
death rate in half, while Vienna, if we may trust 
the figures, has within a century reduced her rate 
from 60 per 1000 of population to 23. Similarly 
the mortality rate in Boston has been lowered from 
an estimated 34 per 1000 in 1700 to 19 today. 

Mr. John K. Gore, actuary of the Prudential In- 
surance Company, shows that the average death 
rates per 1000 of population among typical Amer- 
ican cities was, for the white population, as follows : 

Years. Death Rate per iooo. 

1 804- 1 825 24.6 

1826- 1850 257 

18SI-1863 28.3 

1864- 1875 254 

1876-1888 22.9 

1889-I9OI 21.0 

The record, even of the last thirty years, displays 
a fall in death rates that may inspire us with buoy- 
ant hope for the future. The mortality rate per 
iooo has fallen in Berlin from 33 in 1875 to 16 in 
1904; in Munich, from 41 in 1871 to 18 in 1906; and 
in Washington, from 28 in 1875 to 19 in 1907. 

Between 1890 and 1906 New York lowered her 
death rate per iooo from 25.4 to 18.6 and Boston 
from 23.4 to 18.9. The mortality rate in the whole 
registration area of the United States fell from 19.6 
per iooo in 1890 to 16. 1 in 1906, although the area 
in the last-named year included a larger proportion 
of urban population. 



AND HOW TO PROTECT IT. 127 

We have, also, vital records for the city of Hav- 
ana, running back over a century. These show 
that while the death rate in 1802 was given as 54.6 
per 1000, rising in cholera years even as high as 
103.4 (1833), and in the last year of Weyler's con- 
centration methods as high as 91, the rate during 
the eight years from 1899-1906 ranged from 20.4 
to 33.6. 

These records also show the remarkable and sud- 
den fall that may be brought about by a change 
in the living conditions of a community. During 
the three "concentration" years of 1896, 1897 and 
1898, the mortality rate per 1000 was 51.7, 78.7 and 
91, respectively. In 1899, the first complete year 
of American occupation, the rate dropped to 33.6, 
and since then it has ranged between 20.4 and 24.4. 
There can be no question that the improvement 
was almost wholly due to the sanitary reforms in- 
troduced by Colonel Gorgas, and the other United 
States army surgeons under Gen. Leonard Wood. 

The record of American army sanitarians in the 
Panama Canal zone shows as striking results as in 
Cuba. The death rate in Panama during 1887, when 
the French canal companies held occupation, ran 
over 100 per 1000. In 1906 the death rate was 49 
per 1000, while in 1907 it fell to less than 34. Col- 
onel Gorgas attributes the decrease in the general 
death rate in great part to improved sanitation, 
though he adds that "increased wages, better food 
and better clothing have no doubt played a consid- 
erable part in the general improvement of the 
health." 



128 THE WORKING PEOPLE: THEIR HEALTH 
ADULT AND INFANT MORTALITY 

Mortality varies greatly with age. The improve- 
ment in the city death rate of the past half century- 
has been especially marked among the young. It 
is true that in countries of the same degree of civil- 
ization the infant death rate is remarkably constant, 
but this is probably accounted for by the similarity 
in the methods of feeding of infants. Certainly 
where there is a difference in conditions there will 
be found a difference in mortality. Thus the com- 
parison between the mortality of infants fed on 
cow's milk and those fed on mother's milk, shows 
that the former is five to ten times that of the 
latter. Although the infant mortality rate is prob- 
ably falling, the decrease is not accompanied by a 
lowering of the mortality of later life. There is 
an increased mortality beyond the age of 50 years. 
In Massachusetts the death rates by age changed 
during thirty years as follows : 

DEATH RATE IN MASSACHUSETTS PER IOOO OF POP- 
ULATION IN EACH AGE PERIOD 



Age. 


186s. 


189s. 


5-9 


9-6 


6.2 


IO-14 


5-1 


3-2 


15-19 


9-6 


5-3 


20-29 


12.6 


7-1 


30-39 


11.7 


9-7 


40-49 


12.0 


130 


50-59 


17.0 


20.0 


60-69 


33-0 


39-0 


70-79 


70.0 


82.0 


80 and upward 


168.0 


185.0 



AND HOW TO PROTECT IT. 129 

Here, while the death rate for all age periods 
under 40 has materially decreased, the later periods 
of life have suffered progressive increases in mor- 
tality rate. As Frederick L. Hoffman has expressed 
it : "There is, of course, no question whatever that 
the American death rate, using the term in a very 
comprehensive sense, has substantially declined 
within the last fifty years, but it is equally evident 
that this decline has been at the younger ages and 
not during the period of life which, economically, 
is of the greatest value. There is no doubt that the 
mortality of adult ages is still decidedly excessive." 

The same tendency, viewed from the standpoint 
of the expectation of life, is disclosed in the study 
of two Massachusetts life tables, compiled nearly a 
century apart — one, Wigglesworth's life tables for 
Massachusetts and New Hampshire in 1789, though 
not very accurate; the other, Abbott's Massachu- 
setts life tables for 1893- 1897. 

EXPECTATION OF LIFE IN MASSACHUSETTS 

Age. 

10 
20 

40 

These figures indicate that the expectation of life 
at the earlier ages is much greater than a century 
ago, but that for the age of 60 and upward it has 
remained practically stationary. English life 
tables, for three decades ending 1900, display the 
same tendency. 
9 



1789. 


1897. 


Age. 


1789. 


1879. 


35.5 


45-4 


60 


154 


151 


43.2 


50.0 


80 


59 


6.1 


34-2 


42.0 


90 


37 


34 


26.0 


28.2 









1871-1880. 


1881-1890. 


1891-1900. 


414 


437 


44.1 


394 


40.3 


41.0 


I3-I 


12.9 


12.9 


4-8 


4-5 


4.6 


EMALES 

44-6 


47-2 


47.8 


417 


42.4 


43-4 


14.2 


14.1 


14.1 


5-2 


5-0 


5-1 



130 THE WORKING PEOPLE: THEIR HEALTH 
ENGLISH LIFE TABLES — EXPECTATION OF LIFE 



Age. 

O 

20 

60 

80 




20 
60 
80 

These tables show that there is improvement at 
the younger ages for the period 1891-1900 over the 
period 1871-1880. For ages over 60 there has been 
a retrogression. It is observable, however, that 
between the periods 1881-1890 and 1891-1900 the 
figures for 60 years have remained stationary, and 
for 80 have slightly improved. In other words, a 
baby today has in prospect a much longer average 
lifetime than did the baby of two generations ago; 
but a man or woman 60 years old has in prospect 
an average after lifetime no greater than formerly. 
The proximate cause of this contrast would seem to 
lie in the fact that the mortality from many of the 
diseases of later life has been and is on the increase. 
The death rates from diabetes, heart disease, and 
Bright's disease have all doubled in thirty years. 
Cancer is probably on the increase, and "today one 
in every twenty-one men who have reached the age 
of 35, and one in every twelve women who have 
reached 35, eventually die of that disease." In 
addition there may be mentioned other diseases: 



AND HOW TO PROTECT IT. 131 

arteriosclerosis, nephritis, apoplexy, paresis, dis- 
orders of the liver, and all manner of degeneration, 
all of them maladies of adult life, and all of them 
apparently tending to increase. 

PARTICULAR DISEASES 

We turn now to the ravages made by particular 
diseases in the modern world. The death rate in 
the United States from tuberculosis of all forms 
equals the combined death rate from smallpox, ty- 
phoid fever, diphtheria, cancer, diabetes, appendi- 
citis and meningitis. 

The death rate from tuberculosis of all kinds in 
the registration area was 183.6 per 100,000 in 1907. 
Large as these figures are, they represent a consid- 
erable decrease since 1900. On a par with tuber- 
culosis in the number of its victims in this coun- 
try stands pneumonia. 

The mortality statistics of the last census show 
that in the registration area of the United States 
pneumonia is responsible for 11 per cent, of all 
deaths. Pneumonia is now known to be a com- 
municable disease, the germ of which is very widely 
distributed; but there is great need for special 
researches into the modes of spreading this for- 
midable disease. In the meantime the best protec- 
tion is to "keep in condition." While the germ of 
pneumonia is the exciting cause of the disease, pre- 
disposing causes are acute or chronic alcoholism, 
exposure to cold, extreme exhaustion, and debility 
of any kind. 

Typhoid fever is in some places yielding to pre- 
ventive measures in a most striking manner. The 



132 THE WORKING PEOPLE: THEIR HEALTH 

fall in the death rate from typhoid fever in the reg- 
istration area, from 46.3 per 100,000 of population 
in 1890 to 33.9 in 1900, and to 32.1 in 1906, may- 
be safely ascribed to improvements in the water and 
milk supplies of our cities. The surprising reduc- 
tion of the typhoid-fever death rate in individual 
cities, resulting from definite improvements in the 
water supply, gives direct confirmation of this 
statement. 

The typhoid mortality in Munich during 1856 
was 291 per 100,000 of population. The city at that 
time contained numerous cesspools, and the water 
supply was largely obtained from wells and pumps. 
From 1856 to 1887 there was great activity in the 
filling up of cesspools, the abandonment of pumps 
and wells, and the installation of modern sewers. 
A pure water supply was also 1 secured, the water 
being brought from a distance. The typhoid fever 
death rate fell in 1887 to 10 per 100,000 of popula- 
tion — a reduction of 97 per cent. 

In Hamburg the typhoid mortality for 1880-1892 
ranged from 24 to 88, averaging 39.7 per 100,000. 
In May, 1893, a filtration plant was opened, and the 
rate fell in that same year to 18. For the five years 
following, it averaged only 7.2, showing a reduction 
of over 80 per cent. 

The introduction of a water filter in the city of 
Lawrence, Mass., in 1893 was followed by a reduc- 
tion in deaths caused by typhoid from 105 in 1892 
to 22 in 1896, one-fifth the previous figure. Filter- 
ing the city water in several other American cities 
has shown abrupt declines in the typhoid death rate 
almost as remarkable. 



AND HOW TO PROTECT IT. 133 

Another method of pointing out the importance 
of a pure water supply is to compare the mortality 
rates from typhoid fever of cities that secure water 
from various sources of supply, as the following 
table shows: 

DEATH RATE FROM TYPHOID FEVER PER 100,000 OF 
POPULATION, 1 902- 1 906 

4 cities using ground water from large wells, 18.1 

18 cities using impounded and conserved rivers or 

streams, 18.5 

8 cities using water from small lakes, 19.3 

7 cities using water from Great Lakes, 32.8 

5 cities using surface and underground water, 45.7 

19 cities using polluted river water, 61. 1 

Thus far our studies indicate that typhoid fever 
will cease to be a "problem" in any community 
having clean water and an uninfected milk supply, 
and in which cases of the disease are treated as 
dangerous and contagious. Unfortunately such 
communities are too rare at present. 

Perhaps the most common and neglected source 
of danger of infection from typhoid is the ordinary 
house-fly or, as Dr. L. O. Howard, chief of U. S. 
Bureau of Entomology, would have us call it, the 
"typhoid-fly." 

Smallpox, another disease that yields readily k o 
preventive measures, has decreased greatly in viru- 
lence and mortality since the introduction of vac- 
cination. In Prussia, for example, the death rate 
from smallpox per 100,000 population was 24.4 in 
the period from 1846-1870. In 1874 vaccination, 
which up to that time had been only intermittently 



134 THE WORKING PEOPLE: THEIR HEALTH 

utilized, was made compulsory, and the death rate 
per 100,000 fell at once to 1.5, for the years 1875- 
1886. Other European states have been more lax 
than Germany. In 1886 the death rate from small- 
pox in Switzerland was fifty-fourfold that of Ger- 
many; in Belgium, forty-eightfold; in Austria, 
eighty-onefold, and in Hungary, six hundred and 
sevenfold. Babbage states that "it has been shown 
by M. Duvillard that the introduction of vaccin- 
ation has increased the mean duration of human 
life about three years and a half." Before Jenner's 
utilization of vaccination to guard against small- 
pox, that disease was causing one-tenth of all deaths 
of the human race, just as does tuberculosis today, 
while "nearly twice as many were permanently dis- 
figured by its ravages. In England 300 per 100,000 
population died annually from it. It is computed 
that during the eighteenth century 50,000,000 
people died of smallpox in Europe." Boston was 
visited twelve times by smallpox epidemics in the 
century and a half ending 1800. 

Yet where vaccination has been made compul- 
sory, or where it is generally resorted to, smallpox 
has virtually disappeared. The last census reported 
but 3500 deaths from smallpox in the United States 
in 1900. Even as long ago as 1826 Denmark was 
enforcing the practice of vaccination so vigorously 
that not a single case had appeared for eleven years. 
Havana, during the eight years prior to the Amer- 
ican intervention, reported 3132 deaths from small- 
pox. In 1899, the year following the American 
entry, there were four deaths, and three more dur- 
ing the next seven years — a virtual uprooting of 



AND HOW TO PROTECT IT. 135 

the disease. The present outcry against vaccina- 
tion is based on a misunderstanding, and is one of 
many evidences of the imperative necessity of the 
diffusion of correct knowledge among the people on 
matters of hygiene and preventive medicine. 
Whether vaccination should be made compulsory 
is a fair question, but that it is efficacious is not 
open to question. The argument that because some 
unvaccinated persons escape during an epidemic 
all would escape, is too absurd to deserve serious 
consideration. 

Yellow fever first appeared in serious form at 
Philadelphia in 1793, when one-tenth of that city's 
population died of it in the space of six and one- 
half weeks. Since 1793 the United States has had 
500,000 cases, resulting, it is estimated, in about 
100,000 deaths. In 1900 it was discovered that a 
species of mosquito is responsible for the trans- 
mission of this fever, and in consequence of this 
knowledge and its application, the disease is now 
practically banished from this country. The 
marked decrease in the death rate from yellow 
fever in Havana, since the American intervention 
in 1898, is shown in the following table. The deaths 
from yellow fever numbered 4420 in the eight years 
from 1891 to 1898, while in the eight years from 
1899 to 1906 they numbered but 465. 

YELLOW FEVER DEATH RATE IN HAVANA, 187O-I906 

(Rate per 100,000 population.) 

Before American intervention. After American intervention. 

1870 300.5 1898 67.8 

1880 324.5 1809 42.5 

189O 153.6 1900 I24.O 



136 THE WORKING PEOPLE: THEIR HEALTH 

Before American intervention. After American intervention. 

1895 275.8 1901 6.9 

1896 639.5 1902 

1897 428.0 1903 O 

1904 

1905 8.0 

1906 4-3 

These results have been due partly to the elim- 
ination of the contagion-carrying mosquito and 
partly to the general improvement of the city's san- 
itary appointments. 

The impressive figures just presented, showing 
the fall in mortality from so many of the most dan- 
gerous diseases, point clearly to the value of pre- 
ventive measures in the conflict with disease. The 
fall in tuberculosis mortality is directly due to the 
growing use of hospitals, which have tended to 
isolate consumptives, and to a use of our recently 
acquired knowledge of the efficacy of fresh air and 
the outdoor life; typhoid fever has virtually dis- 
appeared when water and milk supplies have been 
made pure, the open privy abolished, and flies and 
other carriers of the specific cause of the disease 
have been provided against; smallpox has given 
way before vaccination; yellow fever is fast dis- 
appearing, now that the agent of transmission is 
known ; while many of the less serious diseases are 
losing their power, purely owing to preventive 
methods. 

Some diseases, once the scourges of humanity, 
have practically disappeared from the civilized 
world. Scurvy, up to the latter half of the eight- 
eenth century, decimated the armies and fleets of 
Europe. During Anson's famous expedition, about 



AND HOW TO PROTECT IT. 137 

the year 1750, 600 out of 900 died, chiefly from 
scurvy. The use of lime-juice and fresh vegetables 
has practically eradicated the disease. 

"Cholera was wont to visit the cities of the At- 
lantic coast in the past about every ten years, and 
it was a standing menace to the world every sum- 
mer. It was not uncommon for the disease to 
decimate whole towns and cities. Since the discov- 
ery of its cause, however, it has been robbed of its 
terrors, and the children of today will probably 
never know of it except by name." 

Malaria has been on the decrease ever since the 
discovery that the malarial organism is transported 
by a species of mosquito. Even the five years end- 
ing 1906 show a progressive decline in the death 
rate from malarial fever in the registration area. 
The figures are 5.4, 4.3, 4.2, 3.9 and 3.5 deaths per 
100,000 of population, for the five years in ques- 
tion. 

In themselves, the figures are so small as to 
show the virtual disappearance of the disease, at 
least from the Northern States. It is still very 
common in the Southern States. Its evil is by no 
means to be measured by the deaths it causes. It 
produces chronic disability and predisposes to 
other diseases. 

Finally, the furnishing of pure milk to the in- 
fant population of the cities is eliminating year by 
year the infant scourges — diarrhceal diseases and 
related maladies. 

There are of course diseases which show no sign 
as yet of decreasing. The census volume, "Mor- 
tality Statistics of 1906" (p. 29), gives only one 



138 THE WORKING PEOPLE: THEIR HEALTH 

important disease (diabetes) as actually on the in- 
crease within the registration area, but several 
which are given as having "fluctuating rates," such 
as cancer, heart disease and Bright's disease, seem 
still to have an upward trend. 

It is known that malaria is preventable. Why, 
then, is it not prevented in the South? Probably 
for two reasons. First, the facts are not generally 
known, owing to lack of vital statistics in the 
Southern States. Second, owing largely to this ig- 
norance no adequate effort has yet been made. 

The preventability of accidents is beginning to 
be appreciated. It is now proposed by Mr. W. H. 
Tolman to establish in New York a museum of 
safety and sanitation to demonstrate this fact. Mr. 
Frederick L. Hoffman, statistician of the Pruden- 
tial Insurance Company, estimates the number of 
accidental deaths among male workers alone in 
1908 as between 30,000 and 35,000. 



AND HOW TO PROTECT IT. 139 



CHAPTER XIX 

Should the Pregnant Woman Work in 
Factories ? 

A number of European countries now prohibit 
the employment of pregnant women, both before 
and after confinement. Laws placed upon the 
statute books to that effect in this country would 
go a long way towards conserving our national 
vitality. I feel, however, that in this country such 
laws will not be needed if employers will only act 
humanely. Our industrial situation differs so 
greatly from that of other countries that the need 
of a woman working in a factory or mill after she 
becomes pregnant, is, except in a few cases, reduced 
to a minimum. We are told that pregnancy often 
favors the development of phthisis or consumption. 
This is especially true if a woman is predisposed, 
in fact this condition often kindles a smouldering 
fire. Women who are weak and inclined to tuber- 
culosis becoming pregnant, if subjected to long 
hours and constant strain, in some cases, in over- 
heated rooms, fall an easy prey to this dread dis- 
ease. We all know that after a woman becomes 
pregnant, in order that she should bear healthy off- 
spring, she should enjoy the best possible hygienic 
surroundings, and exercise should be taken in the 
open air, free from the clamor of the shuttle or the 
dust of the loom. 



140 THE WORKING PEOPLE: THEIR HEALTH 

I have seen a number of cases in the last four- 
teen years, where a girl got married and then, 
anxious to help the husband furnish a home, had 
continued to work at her old occupation in the mill. 
She would commence to run down, "get tired 
easily," as she termed it, have a little hacking 
cough and then after her delivery of a child, would 
develop what is known to the laity as quick con- 
sumption. The germ was already in her system, 
but only became active when her condition, already 
weak, was made more so by child-birth. 

We as a nation may find, as they have found 
in older countries than ours, that we may yet have 
to pass national and state laws bearing upon this 
important subject, for it is certain if we would pre- 
serve our national health, and after all this means 
our national wealth, we must have laws that will 
protect the health of the generations yet to come. 

Suppose the mother actually escapes disease of 
any kind and her health is not noticeably affected, 
the chances are that the offspring will suffer and 
be born a weakling, be a sickly child, so called, and 
aside from the care be a continual expense, because 
it must have almost continual medical care until 
the tenth year is reached. I have often heard the 
following expression from the lips of a working- 
man : "Doctor, that child has never been well since 
birth and it has taken all I could earn to pay the 
doctor's bills." This outcome ought to be taken 
into consideration before a woman subjects her- 
self to the strain of long hours on her feet in a 
factory or mill, during the period of preg- 
nancy. 



AND HOW TO PROTECT IT. 141 



CHAPTER XX 

The Working People as Spendthrifts, 
and Why? 

If forty per cent, of the advice given to the work- 
ing people by physicians, which they buy and then 
throw away, were utilized, there would be less pov- 
erty, less sickness and millions of dollars saved 
annually by this class. There would be fewer med- 
ical colleges, fewer men following] the practice of 
medicine. 

As it stands today, a man or woman goes to a 
physician with a bad attack of indigestion, for in- 
stance. The physician prescribes for their tempo- 
rary relief and then lays great stress upon the im- 
portance of what they should eat and how they 
should eat it, and tells them if they would find 
permanent relief, they must practice self-denial. 
Do they do it? No! They take the medicine pre- 
scribed, receive temporary relief and then at the 
next opportunity they fill their stomachs with the 
very things the doctor has advised them to avoid. 
Such cases grow worse as time goes on, and sooner 
or later the patient is seized by an attack of appen- 
dicitis which lands him in a hospital, which either 
means death, or if recovery, a lingering illness, the 
Joss of many weeks' pay and a large amount of 



142 THE WORKING PEOPLE: THEIR HEALTH 

strength. Therefore, I say to you working people, 
you are spendthrifts, for your health is your bank 
account and your stock in trade. If you go to a 
lawyer, he gives you no medicine, simply a little 
advice which you closely follow. No matter what 
your friendly neighbor tells you he cannot shake 
your confidence in what the lawyer has told you; 
but you would listen to the story of some person 
who knows nothing of medicine, take his advice, 
disregard the advice that has been given to you and 
return to your physician only when you got so bad 
you could no longer endure the suffering. 

In a recent issue of the World's Work, in an 
article written by Edwin Bjorkman, entitled, "The 
Unnecessary Curse of Sickness," he says: 

"In the Shepard Company stores, the daily ab- 
sences because of ill health were found to average 
2.5 per cent, of all the employees. Using the exact 
figures for three months to make an estimate for 
the whole year, the Siegel-Cooper Company ar- 
rived at a total annual loss of 32,571 days for about 
3100 regular employees (outside of 'contingent 
help'). Thus the number of people absent daily 
because of sickness averaged 3.5 per cent, of the 
whole force. A comparison of these figures with 
those furnished by the employees' benefit associa- 
tion indicates that 0.5 per cent, of the absences 
might be ascribed to serious illness and 3 per cent, 
to minor indispositions. 

"In this connection it should be remembered, 
however, that the rate for illness is lowered by the 
fact that the association does not pay benefits be- 
yond the sixth week. 



AND HOW TO PROTECT IT. 143 

"A census taken at Wanamaker's, March 15th to 
March 20th, 1909, revealed an average daily ab- 
sence of 164 out of a total of 4500 employees, and 
all but a negligible fraction of these absences were 
caused by sickness. The average sick rate for that 
brief period was 3.5 per cent, of the whole force, 
but, allowing for a large decrease during the sum- 
mer months, it is safe to place that rate at 3 per 
cent, for the entire year. The records of the em- 
ployees' benefit association for the twelve months 
ending with February, 1908, showed 1820 days of 
illness among 4500 employees — a rate of 0.77 per 
cent, for the whole force. 

"Everything considered, I feel warranted in 
drawing from these figures the conclusion that at 
least 3 per cent, of the 32,000,000 active workers 
between fifteen and sixty are all the time kept from 
their work by ill health. No distinction is here 
made between illness and indisposition, as it has 
no influence on losses expressed in terms of actual 
absence. Nor shall I for the present have any 
chance to refer to the mildest degree of ill health, 
beyond quoting the declaration of Dr. Luther H. 
Gulick that 'minor ailments are the chief source of 
decreasing our daily efficiency,' and that 'nine- 
tenths of them could be removed by careful atten- 
tion.' 

"According to my conclusion, 960,000 sick men 
and women fail daily to furnish their proper share 
of productive activity. As that number includes 
high-salaried officials and professional men, not less 
than day-laborers and shop-girls, it seems safe, as 
before, to place their average weekly earnings at 



144 THE WORKING PEOPLE : THEIR HEALTH 

$9. This makes a daily loss in earnings of $1,440,- 
000, or about $450,000,000 a year — a sum that bears 
a striking resemblance to those obtained by Pro- 
fessor Fisher and others, by the use of foreign sick- 
ness rates. In fact, comparing the various esti- 
mates arrived at in so many different fashions, it 
seems hardly possible to escape a recognition of 
the sum of $500,000,000 as most nearly approximat- 
ing the annual loss in salaries and wages through ill 
health. Place the proportion paid out for salaries 
and wages as high as 40 per cent, of the value of 
the finished product, and we arrive at a possible 
economical loss of $3,600,000 a day, or $1,116,000,- 
000 a year. And still we have not included the 
sick bill proper — the money spent on medicines 
and medical care and nursing — nor the funeral ex- 
penses. The United States Bureau of Labor has 
published figures showing the annual average expen- 
diture among workers for sickness and death to be 
%2J. On the basis of these ridiculously low figures, 
the annual sick bill of the breadwinners of the 
nation should be about $460,000,000. Still the ill 
health among the unproductive elements of the 
population remains to be taken into account — and 
these elements include children and aged persons, 
among whom the sickness rates are known to be 
many times higher than among the productive 
classes. If we add it all up, we shall easily reach 
the three billions of Dr. Gould's estimate. And, 
even then, we have to bear in mind the losses, not 
to be translated into dollars and cents, which result 
from the constant interference of ill health in 



AND HOW TO PROTECT IT. 145 

all its degrees with the orderly procedure of our 
private lives as well as the life of the nation." 

My conclusion is that one and one-half billion 
dollars are lost each year by the working class, 
fully justifying my contention that they are spend- 
thrifts of that most valuable of all possessions — the 
human health. 

Let us hope in the next decade that this loss will 
not be repeated, for it can ill be borne. 



10 



146 THE WORKING PEOPLE : THEIR HEALTH 



CHAPTER XXI 

School Buildings and the Prevention of 
Disease 

In the training of a citizen and in the building 
of a nation the most important building to consider 
is the schoolhouse. Disease will never be banished 
by medicine and surgery; it must be routed by 
education. No better example of this can be shown 
than the fact that by educational methods, which 
consist principally of the scientific application of 
fresh air and diet, the mortality of tuberculosis has 
been reduced from four hundred thousand to two 
hundred thousand in the last nine years. This has 
been done principally by an educational effort. 
The press has led in the dissemination of 
knowledge. 

Results undreamed of have been accomplished, 
among them the judicious use of schoolhouses. 
The instruction of the young along lines of hygiene 
and health should go hand in hand with instruction 
to the adult in such a manner that they can under- 
stand. You ask how can this be done and how can 
I bring about this result? The plan is simple: 
Start a petition among your neighbors to your 
board of education, asking that school buildings in 
different parts of the city be used for a popular 
course of instruction on personal hygiene and pre- 



AND HOW TO PROTECT IT. 147 

ventive medicine. Will they be attended? Yes! 
Think of the attendance at the course of popular 
lectures given last year at Cooper Union, New 
York. Over a million people attended in one year. 
The danger in any community, whether it be from 
disease or crime, lies in ignorance. In enlightened 
communities crime is reduced to a minimum and 
the same is true of disease. We must know that 
disease and evil exist, we must know their causes, 
before we know how to fight them. 

We could not fight tuberculosis until we knew 
that the cause was a little bacillus and that air and 
sunshine were its worst enemies and its sure death. 
Education tells us that the care of the stools of a 
typhoid patient will practically stop its spread in 
a community, that promiscuous spitting spreads 
the germs of tuberculosis ; and it tells us more — it 
tells us that a perfectly healthy body resists nearly 
every germ causing disease of any kind. 

These are some of the things that may be taught 
if the schoolhouse is utilized for the purpose of 
spreading knowledge which we should all know. 
Ignorance of the laws of nature, coupled with the 
fact that you so often disregard the advice of your 
family physician, is responsible for many lingering 
diseases and perhaps is responsible for one-third of 
all man's ills. Latter-day medical science has 
demonstrated the fact that excesses in all things 
lead to a deranged and diseased body. Bright's 
disease is caused as often by overeating as by over- 
drinking. The word intemperance means many 
things ; it not only applies to drinking, but it ap- 
plies to eating, sleeping, bathing and breathing. 



148 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXII 

Rest in the Prevention of Tuberculosis 

One old physician who had practiced medicine 
for nearly half a century at last arrived at the 
conclusion that after all, rest was the basis of all 
prevention and cure of disease, so he wrote a beau- 
tiful volume entitled, "Rest and Pain." Rest is 
the essential factor in the prevention of disease as 
well as the most potent factor in the cure of dis- 
ease. The reason is perfectly plain. The nervous 
system must be kept in a healthy condition else it 
cannot impart strength and elasticity to our mus- 
cular system. A man may have ever so well de- 
veloped muscles, but if you destroy the nerve sup- 
ply to these muscles, then they wither and die. You 
can destroy the nerve supply to the stomach by 
fatigue and overstrain. What have you then done? 
Prevented the natural action of all the secreting 
glands, causing a condition which renders the 
stomach useless as an organ of digestion; this in 
turn interferes with the blood supply of the whole 
body because proper nutrition is not taken from the 
food you swallow, and depraved blood is the con- 
sequence. Poor blood means that the red blood 
corpuscles which carry oxygen are weakened and 
no longer do their part, and that the white blood 



AND HOW TO PROTECT IT. 149 

corpuscles that always fight germs of every dis- 
ease are also weakened, so you can easily see how 
much easier it is to fall sick than to keep well, if 
you neglect your rest. 

The American people should be the longest lived 
of any nation, because they have better food, better 
wages, better housing and a multitude of advan- 
tages which other nationalities do not have; but 
they do not rest. The American girl does not rest; 
she is continually on the go. After she has worked 
ten hours in a shop or store, she should rest. When 
she is overtaken by incipient tuberculosis and is 
anxious to get well, the first thing that is prescribed 
for her is rest, and she soon finds that it brings 
color to her cheeks and strength to overtired 
muscles. 

The American housewife should remove her 
clothing and give herself up to one hour of com- 
plete rest each day of her life. She would be hap- 
pier, stronger, would sleep better at night, would 
bear stronger offspring, and as a result of all this, 
would hold her age, and when the change of life 
came she would be in a position to ward off the 
multitude of ills that arise at this time. If the 
American woman rested more she would not be- 
come a nervous wreck at the age of forty-five. 

The boy and girl reared in the country are 
stronger than their city cousins, because they rest 
more. I remember well, as a boy, that I had cer- 
tain hours for rest which I must take no matter 
how I felt. I must be in bed at a certain hour, that 
I might get up in the morning. We, as Americans, 
must take more time to rest or we shall decay; we 



150 THE WORKING PEOPLE: THEIR HEALTH 

shall wear out. The automobile that has no rest 
wears out; the horse that has no rest wears out; 
the engine which is not relieved or has no rest is 
short-lived. Why does this not apply to man? 

The young man and the young woman who must 
carve out their future for themselves, must school 
themselves to rest systematically. This applies to 
the student, to the man of business, to the profes- 
sional man and to the scientist. 

If you are afflicted with early tuberculosis and 
must remain at home, the rest cure is your sal- 
vation. Get all the rest you can and get it in the 
open air tempered with sunshine. When weather 
will permit install yourself in the quietest part of 
the house; the back piazza if a yard is not avail- 
able. Avoid too much company, avoid using your 
voice, avoid getting overtired by reading, avoid 
everything that brings about the slightest fatigue, 
and simply rest If you are running a temperature, 
rest absolutely until this temperature is normal and 
has remained so for at least three weeks, then com- 
mence with a mild exercise that does not tire you. 
Sleep a good deal. Close the eyes for an hour at 
a time even if you do not sleep ; this will rest you. 
Place yourself in a reclining chair in such a posi- 
tion that the position itself means rest. Sleep in 
the open air, avoiding draughts. Look, when pos- 
sible, at pleasant pictures ; some good friend will 
always find some good illustrations that are pleas- 
ing and restful. Look on the bright side of life, no 
matter what your station in life. Live one day at 
a time. Remember that our American civilization 
is fast making for better health conditions every- 



AND HOW TO PROTECT IT. 151 

where. Try and pick your associates from those 
with a genial disposition. Eat easily digestible 
food, don't worry, and you will soon be surprised 
at the results you have obtained in a short time by 
learning to rest. 

If you are a working girl or boy, follow out the 
rules laid down while at work, and then if you still 
do not get over that tired feeling, consult a physi- 
cian first and then make arrangements to leave 
your work for a few weeks for a complete rest. 
Don't say that you cannot afford it. You can afford 
anything that will build up your health; you can 
pay a few back bills if you get your health. Many 
a case of early consumption has been brought about 
by going too long without a vacation. Getting 
over-tired is the most frequent cause of rheumatism, 
and I have found cases have developed most often 
in those who have had a long mental as well as 
physical strain. Appendicitis comes on often as 
a result of overtired muscles and nervous system, 
because a peculiar condition is thus set up in the 
bowels. 

In conclusion, I want to say that my experience 
and observations have taught me that whenever a 
daily, nightly, monthly system of rest has been fol- 
lowed, in a period of a few years more working days 
are at the disposal of him who rests than of the one 
who says he cannot afford to take a rest. To repeat 
what I have already said, this complex and perplex- 
ing American life, if we would live longer, must 
have periods of cessation for those in all walks of 
life, so arranged as to suit the individual case. We 
must learn to breathe, to utilize fresh air to its best 



152 THE WORKING PEOPLE : THEIR HEALTH 

advantage, to avoid worry, to bathe properly, to eat 
properly, to practice self-denial, to walk and exer- 
cise properly, and finish it all by a close study of 
the chapter rest and its effects upon body and 
mind. 



AND HOW TO PROTECT IT. 153 



CHAPTER XXIII 
Drinking-cups and their Relation to Disease 

It is now a proven fact that the ordinary drink- 
ing-cup is a carrier of disease, that it may convey 
the germs of the following diseases: Diphtheria, 
meningitis, bronchitis, tuberculosis, pneumonia and 
la grippe. The annual death rate from these dis- 
eases alone, in the United States, is 400,000. It is 
also possible that a person might be inoculated 
with syphilis from a drinking-cup. 

The present system of drinking from public foun- 
tains should be condemned, and in traveling one 
should always carry one's own drinking-cup; the 
common communion-cup should be abandoned, and 
a more thorough system of cleansing of cups at 
soda fountains and public bars should be insisted 
upon by local health boards. 

Through the courtesy of the Technical World 
Company of Chicago, I print below their excellent 
circular bearing directly upon this subject: 

death in school drinking-cups. 

By Alvin Davison, M.S., Ph.D. 

Professor of Biology in Lafayette College, and author of 

"The Human Body and Health." 

"The greatest achievement of science in the open- 
ing decade of the twentieth century is the awaken- 



154 THE WORKING PEOPLE: THEIR HEALTH 

ing of the people to the fact that most human dis- 
eases <are preventable and a large proportion of 
early deaths avoidable. At least 700,000 of the mil- 
lion and a half deaths occurring annually in the 
United States result from the minute parasitic 
plants and animals gaining access to the body. 
These invisible foes wage a continual warfare 
against both strong and weak, rich and poor. Civic 
duty as well as self-preservation demands that these 
life-destroyers should as far as possible be shut out 
of the human system. 

"The death rate in any locality or country is 
usually a true index of the habits and education of 
the people in reference to the protection of health. 
In benighted Spain twenty-seven out of every thou- 
sand inhabitants perish annually, while in enlight- 
ened Norway death claims yearly only fourteen of 
each thousand residents. In New Orleans, the 
death rate among the colored people is forty-one 
per thousand, while among the white race it is 
only twenty-one per thousand. Ignorance and neg- 
ligence in regard to the laws of sanitation invite 
sickness and death. 

"The chief avenue by which bacteria enter the 
body is the mouth. The air, food, water, and espe- 
cially the drinking-cup, are the usual means by 
which the disease-producing parasites are trans- 
ferred from one person to another. The purpose of 
this paper is to consider only the latter in its rela- 
tion to health. 

"The evidence condemning the use of the com- 
mon drinking vessel upon any occasion, whether at 
school, church or home, is derived from three 



AND HOW TO PROTECT IT. 155 

sources: I, the frequent presence of disease-pro- 
ducing* bacteria in the mouth; 2, the detection of 
pathogenic germs on the public cups ; and 3, the 
discovery that where a number of persons drank 
from a cup previously used by the sick, some of 
them became ill. 

"Recent investigations show that the germs of 
diphtheria and grippe frequently remain from one 
to three months in the mouths of the patients after 
they have recovered from the disease. The very 
extensive and careful observations of the Minnesota 
State Board of Health demonstrated that in over 
half of the diphtheria cases, virulent germs re- 
mained in the nose and throat of the patients three 
weeks after recovery. Most careful examinations 
by expert bacteriologists show that many of the 
common sore throats are really light cases of diph- 
theria. Of the 2038 mild sore throats examined in 
the school children of Hartford, Conn., 591 were 
shown to be due to the true diphtheria germ. The 
bacilli now universally employed in the making of 
diphtheria anti-toxin were first isolated from a mild 
sore throat. Bacteria which in one person cause 
only slight illness may, when transferred to an- 
other individual, produce serious disease and death. 
This widely different effect of the same germ may 
be due to the variation in the germ-killing power of 
the body tissues, or it may result from new associ- 
ation with other germs. 

"It is an established fact that a considerable num- 
ber of well persons harbor in their mouths the 
germs of grippe, pneumonia, diphtheria and ton- 
silitis. Examination of 4250 persons by the Mas- 



156 THE WORKING PEOPLE: THEIR HEALTH 

sachusetts Association of the Boards of Health 
showed that over one hundred of them carried in 
their mouths virulent diphtheria germs. Penning- 
ton in 1907 found virulent diphtheria bacilli in 
nearly five per cent, of a large number of appar- 
ently healthy school children in Philadelphia. In 
Minnesota true diphtheria germs were found in the 
mouths of seventy persons in every thousand exam- 
ined. The average results of a large number of 
investigations demonstrate that nearly one per cent, 
of well persons carry in their mouths true diph- 
theria germs. In Boston sixty per cent, of all 
cases of common catarrh examined showed the 
presence of grippe bacilli. Considerable evidence 
is at hand showing that the germs of sore throat, 
pneumonia and bronchitis are present in many 
people who mingle with the well and drink from 
the public cups. 

"During the past six months I have investigated 
by means of direct microscopic examination, by 
cultures and by guinea pig injections, the deposits 
present on various public drinking vessels. Cup 
No. 1, which had been in use nine days in a school, 
was a clear, thin glass. It was broken into a num- 
ber of pieces and properly stained for examination 
with a microscope magnifying 1000 diameters. The 
human cells scraped from the lips of the drinkers 
were so numerous on the upper third of the glass 
that the head of a pin could not be placed any- 
where without touching several of these bits of 
skin. The saliva by running down on the inside 
of the glass had carried cells and bacteria to the 



AND HOW TO PROTECT IT. 157 

bottom. Here, however, they were less than one- 
third as abundant as at the brim. 

"By counting the cells present on fifty different 
areas on the glass as seen under the microscope, it 
was estimated that the cup contained over 20,000 
human cells or bits of dead skin. As many as 
150 germs were seen clinging to a single cell, and 
very few cells showed less than ten germs. Be- 
tween the cells were thousands of germs left there 
by the smears of saliva deposited by the drinkers. 
Not less than a hundred thousand bacteria were 
present on every square inch of the glass. Most of 
these were of the harmless kind abundant in the 
mouth, but some were apparently the germs of 
decay feeding upon the bits of the human body 
adhering to the cup. 

"In order to determine how much material each 
drinker is likely to leave on the cup, I requested 
ten boys to apply the upper lip to pieces of clean 
flat glass in the same way as they touched the 
glass in drinking. These glass slips thus soiled 
were properly stained for microscopic examination, 
which showed an average of about 100 cells and 
75,000 bacteria to each slip. 

"The results of the examination of cups No. 2 
and 3, taken from a school-room, were similar to 
those of No. 1. Cup No. 4, which had been appar- 
ently in use for several months without being 
washed, was secured from a high school. It was 
lined inside with a thin brownish deposit. This 
was washed off with ten cubic centimeters of sterile 
water and a sterile swab, and the washings were 
then placed in a conical tube which was put into 



158 THE WORKING PEOPLE: THEIR HEALTH 

a centrifuge and rotated rapidly until all the solid 
matter settled to the bottom. By spreading this 
sediment over a half square inch of each of twenty- 
two slides and staining it, the characteristic feat- 
ures were easily made out under the microscope. 
Particles of mud, thousands of pieces of skin from 
the mouth, and millions of bacteria constituted the 
mass. To determine whether any of these germs 
belonged to the disease-producing group, ten of 
the slides were treated with the stain and acid, serv- 
ing to show the characteristics of bacillus tuber- 
culosis. On one of these slides was clearly shown 
a clump of scores of germs corresponding in all 
details to those of tuberculosis. As occasionally 
other germs are met with having the same stain- 
ing qualities and microscopic appearance as those 
of tuberculosis, I procured another cup from the 
same school to apply the final test for detecting 
those relentless enemies which prey upon human 
flesh and add daily to the city of the dead in our 
own land victims to the number of 400. 

"The washings from this cup were sedimented in 
the centrifuge tube. One-third of the sediment was 
injected under the skin of a healthy guinea pig, and 
another third was used in inoculating a second 
guinea pig. The first animal died forty hours after 
receiving the injection. A microscopic examination 
of the blood in the heart revealed the presence of 
numerous pneumonia germs which when planted 
on blood serum and agar, kept in an incubator at 
body temperature for two days, developed the 
characteristic growth of FraenkeFs pneumococcus. 
This experiment gave undoubted evidence that the 



AND HOW TO PROTECT IT. 159 

germs of pneumonia had been present in sufficient 
numbers in the cup to cause blood poisoning or 
septicemic pneumonia in the animal. 

"The second guinea pig injected with the cup 
sediment was killed five weeks later. The autopsy 
revealed numerous tubercular foci in the liver and 
several much enlarged tubercular lymph glands. 
Microscopic examination of the diseased tissues 
proved the presence of the true bacillus tubercu- 
losis. By careful inquiry it was learned that sev- 
eral pupils in the school from which the tubercle- 
bearing cups were secured, were then sufferers 
from tuberculosis. In the light of recent discov- 
eries, showing that tuberculosis is not usually 
acquired by inhaling the germs, but by receiving 
them with food or by mouth-contact with objects 
soiled with tubercular deposits, does it not seem 
probable that the drinking-cup may very often 
serve as the transmitter of the white plague? 
Doctor Anders of Philadelphia by means of guinea 
pig inoculations demonstrated the presence of 
tubercle bacilli in two out of five specimens from 
the dregs of common communion-cups. 

"In order to make a further study of the germs, 
a third portion of the sediment from cup No. 5 
was planted in culture media, serving to isolate the 
various kinds of bacteria so that the characters of 
each might be observed. Ten different species 
were thus separated and examined. Streptococci, 
apparently the same as those occurring in sore 
throat and tonsilitis, were present, as was also the 
common pus germ staphylococcus aureus. Doctor 
Anders has reported the discovery on the com- 



l6o THE WORKING PEOPLE: THEIR HEALTH 

munion-cups, from a Philadelphia church, of nu- 
merous pus germs as well as pus cells. 

"The microscopical examination of cups Nos. 6 
and 7 secured from a railway station and a club- 
house showed numerous cells from the lips, and 
thousands of bacteria present in the upper portion 
of the vessels, although they appeared quite clean 
to the naked eye. Cup No. 8, taken from a rail- 
way station, was the only vessel examined that 
could be called reasonably clean. Its surface car- 
ried only two or three human cells to the square 
inch and upon the same area were less than five 
hundred bacteria. 

"A third source of evidence condemning the pub- 
lic cup is found in the report of Doctor Forbes, of 
Rochester, who refers to an epidemic of diphtheria 
in his city, which occurred among twenty-four per- 
sons and was traced unmistakably to a common 
drinking-cup which all the sick had used. Ton- 
silitis and sore throat are known to affect a larger 
number of pupils in schools where a common drink- 
ing-cup is used than in those schools where the 
individual cup is required, or the sanitary drinking 
fountain has been installed. 

"The mortality statistics of the Census Bureau 
show that diphtheria, meningitis, bronchitis, tuber- 
culosis, pneumonia and grippe, all of which are 
likely to be acquired by the use of the common 
cup, are responsible for nearly 400,000 deaths 
annually in the United States. This fact indicates 
that the germs of these diseases produce in a single 
year more than a million cases of serious illness. 
The financial loss to the country and the mental 



AND HOW TO PROTECT IT. 161 

anguish as well as bodily suffering due to these 
preventable diseases, call loudly for the banishment 
of the unsanitary and filthy common communion- 
cup, as well as the public drinking-vessel, befouled 
with human excretions shielding the darts of death. 

"More than ten thousand churches have now 
adopted the individual communion-cups, and many 
schools either provide a sanitary drinking fountain 
or require the pupils to use individual cups. In 
many places in Germany, pasteboard cups are fur- 
nished, which after being once used are destroyed. 
Wherever hygienic measures have been adopted in 
a community, sickness and death have decreased. 
By living more in accordance with the rules of hy- 
giene, New York city reduced her death rate from 
25 per thousand to 18 per thousand during the 
period from 1890 to 1905. Within the same years, 
Chicago has reduced her death rate from 19 to 14 
per thousand. 

"In Circular 127 of the* Bureau of Animal Indus- 
try, issued April 4th, 1908, are these words: 

" 'The inhalation theory to account for the occur- 
rence of pulmonary tuberculosis has been shown 
to be no longer tenable, because no substance can 
be carried into the finer bronchioles by the respi- 
ratory process, and because tuberculosis lesions in 
the lung have been shown to spread from the vas- 
cular system, the finer capillaries, and not from the 
air passages. Dried and pulverized tuberculous 
material has been shown to lack infectiousness, and 
the infectious spray discharged from the mouths of 
tuberculous persons during speaking and coughing 
has been shown to be of importance only in their 
11 



162 THE WORKING PEOPLE : THEIR HEALTH 

immediate environment, unless such persons are 
permitted to handle articles of food, to which the 
larger droplets of the spray may adhere. The in- 
troduction of bacilli into the body through the un- 
injured wall of the digestive tract, anywhere from 
the mouth downwards, is the chief mode of infec- 
tion with tuberculosis/ " 



AND HOW TO PROTECT IT. 163 



CHAPTER XXIV 
Flies and their Menace to Health 

Perhaps no better title to this chapter could be 
written than that taken from an extract from the 
Government Bulletin No. 78, which reads, "From 
Flies and Filth to Food and Fever." The name 
typhoid-fly is given as a substitute for the name 
house-fly now in general use. The typhoid-fly 
possesses importance as a disseminator of tubercu- 
losis. The number of bacteria on a single fly may 
range from 550 to 6600. The importance of keep- 
ing flies, as agents of disease, from private houses, 
cannot be overestimated. Why? Because flies are 
disease carriers; because they live and breed in all 
kinds of filth ; because they infect food and drink 
by germ-laden feet. Each female fly can lay 150 
eggs, every one of which in turn becomes another 
fly. Flies are fond of feeding on tuberculosis 
sputum. The specks of flies contain live tubercle 
bacilli. After they have eaten this sputum, they 
carry in their mouth proboscides and on their legs 
putrefying and disease germs on which they have 
recently fed and then crawl over food, infecting it. 

Keep flies from the sick, especially those ill with 
communicable diseases. Don't forget that flies will 
carry the bacilli of typhoid fever from the stools of 
a patient, left exposed and not disinfected, to the 



164 THE WORKING PEOPLE: THEIR HEALTH 

food in the kitchen and dining-room. This is no 
conjecture, for the Spanish-American war proved 
this fact. Look carefully after cuspidors; remem- 
ber that where absolute cleanliness prevails, there 
must be no flies. Look daily after your garbage 
can; do the same thing with your stable. Flies 
breed in horse manure, decaying vegetables and 
garbage of all kinds. 

As I am writing this article I am making an in- 
vestigation into an outbreak of typhoid fever in a 
small village in an adjoining town. Here nine 
cases have developed within the last two weeks. 
The water supply seems to be good, and the only 
reason that I can find for this spread of typhoid 
fever is the fact that the common house-fly has 
been "getting in his work." In this particular vil- 
lage the old-fashioned earth privy is still in exist- 
ence, and in several instances we have found 
swarms of flies gathered about these privies. They 
then make a journey to neighboring houses and 
deposit the bacilli upon the food eaten by the 
people. This is only one of many cases which I 
might cite which has come under my observation 
either in my own practice or by having my atten- 
tion called to it by other physicians. 

It is a well-known fact that in the so-called dry 
seasons, when the atmosphere is humid and the 
water is low in well or swamp, we seem to have 
an abundance of flies and also an abundance of 
typhoid fever. The question of infection from the 
source of flies is so recent that literature upon this 
subject giving absolute facts and statistics is very 
meagre. It is my belief, however, within the next 



AND HOW TO PROTECT IT. 165 

ten years that old question of "where did he or she 
contract this disease ?" in many cases will be cleared 
up and traced to the flies. 

If you are living in the country and you have 
a case of typhoid fever in your home, avoid doing 
what I have seen done in this recent epidemic, 
namely, depositing the stools near the house. In 
this case a hole in the ground about three feet deep 
and two feet wide should be dug. Into this should 
be placed an abundant supply of chloride of lime, 
which is very cheap and one of the most powerful 
disinfectants we have. Each stool of the patient 
should be emptied upon this lime and covered with 
earth, adding lime from time to time as the case 
goes on. The odor of the lime will keep the flies 
away and consequently the possibility of spreading 
the disease from this source will be very slight. 

One important step now being taken by many 
local boards of health is the covering of meat in 
the public markets. This does away with the 
danger of flies, which, having come from some filth 
district, deposit germs upon meat which are some- 
times not destroyed, even by cooking. 



166 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXV 

The Modern Factory and what it Means to the 
People Employed Therein 

Wise and judicious laws are fast being enacted 
in every state for a better system of factory hy- 
giene, particularly in Massachusetts and New 
York. The utmost care is being exercised not only 
in factory construction, but in making provision 
for better and more sanitary conditions in those 
already in use. The employer has learned that you 
can do more and better work in a well-ventilated, 
well-lighted factory than in one of the old kind. 
It has become a business proposition with the 
manufacturer, as well as a law of many states, that 
better provisions are made in factories for pure air 
and sunlight than are made in your own homes. 
Many of you who work in factories would do well 
to copy some of the rules of hygiene observed 
there and take them home. It means dollars and 
cents to you; it is a sane business proposition, for 
I have told you that your health was your capital. 
In a few years every state will have passed laws 
for tenement-house inspection. Indeed, we never 
shall stamp out tuberculosis until we have the co- 
operation of your landlord and yourself. Many 
cases of consumption emanate from dusty trades 
and ill-ventilated workrooms, but many more have 



AND HOW TO PROTECT IT. 167 

their origin because you excluded fresh air and 
sunshine from your homes. The bacilli of tuber- 
culosis live and thrive only in dampness and foul 
air. Sunshine and fresh air are its destroyers. 

The modern factory, as it is being constructed 
and maintained today, gives you a place ten hours 
in a day where you can breathe fresh air while you 
work. Yet in many instances, as State Inspector 
of Health, I have found factories well supplied with 
windows where fresh air might be admitted, yet 
employees kept them closed against the advice of 
the owner because they were afraid of taking cold. 
This is all wrong. Remember you take cold in foul 
air, not fresh air. Patients sent to Rutland and 
similar institutions do not take cold when sub- 
jected to fresh air and sunshine. Behind closed 
windows and drawn curtain-shades you contract 
consumption, and then to cure the disease you 
immediately seek for places where fresh air and 
sunshine are the only treatment. 

One great trouble with the working people is 
that they do not think for themselves. Remember 
th.at the conservatism of the past has been rele- 
gated to the background, and that the press, to 
which you have access for a few cents a day, is 
spreading the gospel of truth and preventive medi- 
cine. Read less "ads" of quacks and their cures, 
keep your money in your pocket and follow the 
teachings of works like this, written by men with 
your best interest at heart, which are telling you 
every day how to live. 

The man you work for who has been successful 
in business has never allowed anyone to do his 



l6S THE WORKING PEOPLE: THEIR HEALTH 

thinking for him. He has done it for himself; and 
this you must do if you would have capital, that 
is, health. 

In a certain factory, which from a hygienic point 
of view is one of the best in New England, there 
have been four cases of tuberculosis in the last six 
months. Do you think the disease originated in 
this factory? No. It started in the home, but it 
developed in the factory because the employee was 
obliged to work and tire the body and lessen its 
resistance. Should the manufacturer be willing to 
help you to get rid of your trouble because it made 
its appearance while in his employ, give him your 
cooperation, and between employer and employee 
we shall soon stamp out consumption. Your sleep- 
ing room, your late hours, your carelessness out- 
side of your factory hours, all contribute towards 
fanning into flame a fire, whether it be started in 
the factory or the home. 

The physician, the social worker, the hospital, the 
press, all give you advice that is valuable, which 
in many instances is cast aside until disease over- 
takes you, and then many of you hasten to a magic 
healer, because you want a quick cure. One so- 
called magnetic healer in this city boasts of 750 
patients a week at $2.50 each, — think of his income! 
And you pass the doors of reputable men who are 
willing to give you honest and sound advice and 
do not ask you for advance payments. 

Study how to prevent disease, not how you may 
be cured. Remember that every serious illness, no 
matter how complete the recovery, makes you more 
susceptible to another attack. 



AND HOW TO PROTECT IT. 169 



CHAPTER XXVI 
Appendicitis 

Inflammation of the vermiform appendix. The 
most important of all acute intestinal disorders. 
To the work of American physicians belongs the 
honor of its early discovery. Dr. Pepper in 1889 
described the relapsing; form. Dr. Fitz in 1886, by 
his exhaustive articles, served to put the whole 
question on a rational basis. Dr. Willard Parker 
was the first to advocate early operation. Dr. 
Treves, of London, has been foremost in advocating 
proper surgical treatment. 

It is a preventable disease and in seventy per 
cent, of all cases which send you to the surgeon, 
early attention to a few simple health rules would 
have warded it off. The laity were early taught 
that foreign bodies, such as seeds of fruits, bits of 
bone, etc., lodging in the sac, were the cause, but 
of 152 cases studied by Dr. Fitz, only twelve of 
them were found to have this element as causes. 
Micro-organisms working in the intestines form- 
ing solid masses are the most common causes, 
coupled with constipation, causing an abnormal 
condition which places the system in a condition 
where these organisms may work to an advantage. 
When this takes place a catarrhal condition of the 
bowels is found. Many cases, too numerous to 



170 THE WORKING PEOPLE: THEIR HEALTH 

mention, have been described, but my experience 
of fourteen years in general practice has led me to 
believe, and this belief has been strengthened by a 
study of many other men, that in 90 per cent, of 
all cases of appendicitis there is a lowering of the 
general health, setting up abnormal conditions in 
the bowels, before the disease will flourish to any 
extent. 

HOW TO PREVENT APPENDICITIS 

First of all, look to the general health. Follow 
the advice of previous chapters on eating and sleep- 
ing; avoid constipation in every form. If the 
bowels will not move each day, try the use of some 
simple laxative, then resort to an injection. One 
quart of warm water to which a little soap has 
been added, tablespoonful of Rochelle salts, table- 
spoonful of glycerine added to each injection. 
Above all, if you are working and feel tired take 
a rest and a complete change. A trip to the coun- 
try for a couple of weeks with a change of water 
will often ward off an attack of appendicitis. 
Unless the bowels move each day, freely, use the 
above injection twice each week. Remember that 
every pain in the side does not mean appendicitis, 
but it is a signal to consult a physician if the above 
rules do not remove the cause. A sharp pain in 
the right side, with tenderness, the pain extending 
to the centre of the bowels and sometimes up into 
the stomach, a pain which does not let up, are 
pretty sure signs that you should consult your 
physician. Do not wait three or four days, but 



AND HOW TO PROTECT IT. 171 

after ten hours at the longest, call him. Whenever 
this pain is first noticed use an enema at once, and 
for this purpose, to the quart of water and soap 
add one-half teaspoonful of spirits of turpentine; 
inject into the bowels. Relief can often be obtained 
while waiting for your physician by adding a table- 
spoonful of turpentine to a quart of hot water, 
wringing out a large piece of flannel in this and 
applying it to the bowels, renewing it every half 
hour. 



1/2 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXVII 
Dyspepsia, and how to Avoid it 

This disease is the most common of all diseases 
and is no respecter of persons. Old and young, 
rich and poor, alike suffer. Its many forms need 
not interest you, but the avoidance of any form 
should always be your aim. Why? First, because 
acute indigestion is often fatal ; and second, because 
if the food taken into the stomach is not digested 
the whole body suffers for nutrition, which it must 
have if we would maintain good health. Therefore, 
coming to the point at once without any lengthy 
discussion of the subject, I am going to lay down 
a few simple rules which I have used in my pri- 
vate practice for the last twelve years and always 
with success when they are lived up to by the 
patient. 

i. Getting overtired; this is one of the most 
common causes, therefore avoid. 

2. Worry; another common cause; avoid. 

3. Overeating, overdrinking. Drinking with the 
meals is a very poor habit and can easily be over- 
come. If the stomach troubles you in any way, or 
if you would avoid having it trouble you, continue 
reading: 



AND HOW TO PROTECT IT. 173 

GENERAL RULES 

Small meals taken at regular intervals. Punctu- 
ality is of great importance. Masticate thoroughly ; 
eat slowly and learn to eat without drinking with 
food. 

MAY TAKE 

Soups. — Small quantity. Clear soups of beef, 
mutton, oyster. A little vermicelli or tapioca may 
be boiled with these. Tomato soup. 

Fish. — Raw oysters, weakfish, whitefish, shad, 
cod, perch, trout, bass, smelt, fresh whiting. 

Meats. — Meat-juice, roasted or boiled beef, mut- 
ton, chicken, tripe, venison, tongue, sweetbread, 
lamb chops, roast partridge, woodcock, plover. 

Eggs. — Raw, soft-boiled, baked, poached; eat dry 
toast or stale bread with eggs. 

Farinaceous. — Bread at least one day old, rye, 
gluten, and graham bread, zwieback, crackers, 
cream crackers, cracked wheat, rice, sago, tapioca, 
macaroni with toasted bread crumbs, corn meal, 
hominy, wheaten grits, graham grits, vermicelli, 
rolled rye, rolled oats, rice cakes, browned rice, 
baked flour, granose, cerealin, aleuronat toast (es- 
pecially if hyperacidity). 

Vegetables. — (Best made into puree by passing 
through a colander or mashing.) Greens, spinach, 
lettuce, water-cresses, sweet corn, green peas, 
asparagus, artichokes, baked tomatoes, potatoes 
(but little). 

Dessert. — Fruit, rice, tapioca, Indian puddings, 
custards (rice, snow, rennet, sponge-cake, floating 



174 THE WORKING PEOPLE: THEIR HEALTH 

island), orange charlotte, blanc mange, baked and 
stewed apples and pears, baked bananas, grapes, 
and most ripe fruits if fresh. No rich sauces. 

Beverages (drinks should mostly be taken near 
the end of and between meals). — Hot water before 
meals, milke Vichy, weak tea (one-half ounce to 
the pint), koumiss, weak cocoa, buttermilk, malted 
milk, leguminose cocoa, whey, equal parts of whey 
and unfermented grape-juice. Black coffee and 
lemon-juice on first rising. Tea and coffee disagree 
in many cases. Mineral waters: Carbonic water, 
Congress, Ballston, Kissingen, Apollinaris, Poland, 
Highland Spring. 

Stimulants. — Claret, hock, whiskey or brandy, 
and water. 

MUST AVOID. 

Rich soups and chowders, all fried foods, hot or 
fresh bread, griddle-cakes, doughnuts, veal, pork, 
liver, kidney, hashes, stews, pickled and corned 
meats, preserved and potted meats, turkey, goose, 
duck, sausage, salmon, salt mackerel, bluefish, sar- 
dines, lobster, crabs, cabbage, cauliflower, rad- 
ishes, cold slaw, cucumbers, parsnips, egg-plant, 
turnips, carrots, squash, oyster-plant, sweet pota- 
toes, beets, pastry, pies, made dishes, nuts, dates, 
jams, dried and candied fruits, candies, cheese, 
strong tea, ice-water, malt liquors, spirituous 
liquors. 



AND HOW TO PROTECT IT. 175 



CHAPTER XXVIII 
Dangers of City Life 

While I am writing this chapter, Dr. T. Alex- 
ander MacNicall in speaking to the members of the 
American Medical Association makes the startling 
assertion that in the city of New York 70 per cent, 
out of thirty thousand school children are using 
alcoholic stimulants in varying quantities, and of 
the children found to have parents addicted to the 
use of alcohol, 71 per cent, show signs of degen- 
eracy. 

Under the caption of dangers of city life much 
could be written upon diseases not alcoholic and 
not connected in any way with alcohol, which 
would startle every person not a physician, because 
so little ever comes to light. The origin of many 
forms of nervous diseases is never clearly disclosed, 
because the history of the grandparent cannot be 
ascertained. I am not taking issue with Dr. Mac- 
Nicall upon the subject, neither am I greatly sur- 
prised at his statement. Take the enormous num- 
ber of school children in a city like New York with 
its mixture of nationalities and their environments, 
taking into consideration the manner in which 
thousands live, and the only wonder to me is that 
there is not more intemperance and crime; one 
wonders why more people are not driven to drink. 



176 THE WORKING PEOPLE: THEIR HEALTH 

On a summer night you will find the long piers 
extending out into East River literally covered with 
mothers carrying their babies in their arms, seek- 
ing relief from the terrible heat of the Bowery and 
east side slums. Others will be found crowding 
into the parks in great numbers to get a breath of 
air not contaminated by dust and stench. Some 
say half of the world does not know how the other 
half lives. I say that less than 10 per cent, of 
our people have any conception whatever of the 
actual mode of living of the other 90 per cent. ; of 
their comparatively few pleasures, and of the 
amount of suffering, self-denial, self-sacrifice made 
by this great mass. 

Not all of the dangers of city life arise from 
intemperance, but in the squalid quarters of every 
great metropolis a gradual degeneration must con- 
stantly be taking place in the systems of those 
forced by their circumstances to breathe carbon 
dioxide, that poisonous gas, instead of pure air. 
Foul air leads to a loss of appetite and a disordered 
stomach, the craving of which often leads to strong 
drink. 

The boy or girl from the country, coming into 
the city, should learn early that in order to main- 
tain the same standard of health that he or she 
enjoyed in the country home, certain rules must be 
adopted relative to eating, sleeping, breathing and 
exercise that were not necessary in the country. 
The vitiated air of the city contains much less 
oxygen than the country air which is pure ; and yet 
with the simple observance of a few rules, making 
this a part of the daily routine, much can be accom- 



AND HOW TO PROTECT IT. 177 

plished. Some people feel safe on reaching the city 
because they can reach a doctor so easily if they 
are taken sick. They take chances that they would 
never take in the country, which is all wrong. The 
excuse for being careless about one's self is ex- 
plained in this way, "Oh, I haven't the time to 
think of myself." A little more thought of self, 
a little less thought of good times, of "making 
dates," of killing time, would make many an empty 
bed in hospital wards. 

Being connected with a large city hospital, look- 
ing over the history of hundreds of persons ad- 
mitted, I often marvel at the large number of 
people who are made victims of disease simply be- 
cause they persist in doing the very things which 
they well know will undermine their health. On 
taking up your abode in a city, at once begin to 
make a study of the causes that lead to disease, and 
avoid such things. Select first of all the largest 
and sunniest room available, and remember the best 
is none too good. Remember, too, that epidemics 
and continued sickness follow certain localities 
just as sure as a stream of water follows a valley 
or depression in the earth. After choosing your 
room, determine on your mode of living. Keep 
your windows open, take regular exercise. So 
many simple methods are at hand today that there 
is no excuse for neglecting this important measure. 
Pay especial attention to your bathing, to your 
breathing, and especially to your diet. Even 
though you dine at a restaurant you can make use 
of that old axiom, "Know thyself." You can study 
your own digestive powers, you can soon learn 
12 



178 THE WORKING PEOPLE: THEIR HEALTH 

what agrees with you and what hurts you. You 
can learn with a little thought the causes of many 
of the ailments that city folk are afflicted with. 

Live on plain and nourishing food, which need 
not necessarily be expensive. Among the many 
things which you should learn are these : Cultivate 
a desire to walk for exercise and walk right, for 
while you walk you can put into practice the art 
of breathingl properly. The habit of lying down 
in a room filled with cigarette smoke, with the 
windows closed, reading books of no value, is a 
vicious habit which should be shunned. Open the 
windows, keep them open, go out into the open air 
for proper exercise in walking and breathing; stop 
short of fatigue. Get over the habit of thinking it 
is smart of you, as a young man, to go out and 
"fill up" on beer. A poorly nourished body alone 
craves for unnatural stimulation. Spend that 
money in becoming a member of the Young Men's 
Christian Association, join the young men's gym- 
nasium, where proper exercise and proper bathing 
can be practiced and where the atmosphere is cor- 
rect, both from a moral as well as from a hygienic 
standpoint, and avoid the late hours indulged in by 
many of our young men of today, and you will be 
surprised in a year or two to find how nicely you 
are getting along, not only physically but finan- 
cially. 

Choose your companions with the same care you 
would choose an apple or peach, and read the best 
books available. I 

If you are a girl the question is practically the 
same from a standpoint of choosing your compan- 






AND HOW TO PROTECT IT. 179 

ions and associates. I am sorry to say all the 
opportunities today that are open to young men do 
not exist in your case, yet as time goes on and 
conditions change, which they are doing most rap- 
idly, an enlightened public conscience will by its 
influence create for you opportunities that will 
lessen many a burden which the working-girl now 
carries. 

While you have a sound body and mind — and the 
two go together — you can get along nicely. Society, 
while it looks upon the weak with pitying eyes, has 
to operate in a commercial world which looks on 
humanity with an eye simply to business, and the 
first question is, "Have you always had, and do you 
now, enjoy good health?" 

To the honest working-girl I want to say that 
behind the apparent gloom of our present indus- 
trial situation a sunlit future is hidden. No one 
but the mother and the physician knows the temp- 
tation and strain, both mental and physical, to 
which you are subjected. But education will mean 
better sanitary conditions for you in both factory 
and home. Hotels and boarding-houses will yet 
be established where you can live properly. While 
you are waiting, and are living and working under 
the existing circumstances, I want to say, "Guard 
well your health, for this is your capital of which 
you yourself are the chief custodian." 



180 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXIX 

Rheumatism, its Cause and Prevention 

No disease is more dreaded today than rheu- 
matism, and rightly so. It is a disease that has 
been called incurable, and in many instances that 
is, alas, true. Many theories have been advanced 
as to the causes of rheumatism. Among them are 
eating large quantities of the red meats, catching 
cold and the excessive use of alcoholic stimulants. 
While these are no doubt factors, still to my mind, 
based upon the experience of fourteen years in the 
general practice of medicine and upon conclusions 
drawn from my studies of those who were in a 
position to know, I think too little stress has been 
laid upon the most common cause of rheumatism, 
namely, getting overtired. 

If you trace a history of a case of rheumatism 
to its start, you will find that the patient will tell 
you he never had rheumatism in his life until 
he had been two or three years without a vaca- 
tion, or until he had been subjected to some pro- 
longed, severe physical or mental strain. Take a 
ward in any hospital where there are many cases 
of rheumatism, acute, sub-acute and chronic, and 
you can invariably trace 80 per cent, of them back 
to a history of getting overtired and "run down." 
The free accumulation of uric acid in the system is 



AND HOW TO PROTECT IT. i8r 

probably the cause of a large amount of our rheu- 
matic affections, and it is only when the nervous 
and muscular systems are overtired that the heart, 
lungs and kidneys fail to do their work properly. 
Then these poisons, uric acid being the most com- 
mon, having accumulated in the system by reason 
of the inactivity of the tissues, owing to the de- 
fective circulation traced back to the tired heart, 
rheumatism results. 

To avoid rheumatism, avoid, first of all, allowing 
your general health to run down, and absolutely 
avoid the taking of alcoholic stimulants. To bring 
about the so-called natural condition of the over- 
tired tissues, avoid eating too heartily. Because of 
the enfeebled digestive organs you cannot assimilate 
the food. Drink freely of cold water at all times 
except meal-times. If more cold water was drunk 
there would be less rheumatism. Avoid wetting 
the feet, take proper exercise, avoid sleeping in 
rooms with closed windows and you have gone a 
long way towards the prevention of this disease 
which, when once contracted, is often most difficult 
to shake off. 



182 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXX 
The Open-air School and its Wisdom 

Once upon a time in a city of Greece, whose 
citizens were greatly interested in the nurture and 
training of children, the question arose as to 
whether they should build a great public school or 
open a playground. The casting vote was given in 
favor of the playground. Now, in the course of 
years it came to pass that the citizens of that city 
advanced so far beyond the rest of the human race 
that in all the years that have elapsed, even unto 
this day, the cities that have builded schools and 
neglected to open playgrounds have never been 
able to catch up. Reader, if you have children, 
educate them ; but do not neglect their outdoor life. 
They need the sun and the soil as much as the 
plants in your garden or in the window-boxes in 
your windows. Do not hurry the little ones off 
to school. Let them play and romp in the open 
air until they are six years old at the very least. 

Today, on a journey through the country, I saw 
a lad of five following his father at the plow. Shoe- 
less and hatless over the uneven soil he sped as 
lively as a colt, exercising every muscle in his 
little body; filling his lungs with pure air, and 
thus enriching his blood at every step. He was 
laying the foundation for a constitution which will 
be his capital in the years to come. 



AND HOW TO PROTECT IT. 183 

If you would spoil a colt harness it to the plow 
when it is two years old, or drive it to the limit 
of its endurance. Knowledge of this fact lies be- 
hind all our child labor legislation. The law and 
humanity both demand that the child shall have an 
opportunity to develop along! natural lines until the 
age of puberty is reached, and that the body shall 
not be stunted or the mind impaired by excessive 
work and study at the very sunrise of life. 

Keep your child in the open air. Don't put chest 
protectors on him, but rather teach him to breathe 
properly. Teach him to eat properly, to masticate 
his food thoroughly, and to eat at regular intervals. 
Feed him on nourishing but not rich food; give 
him fruit instead of candy. Early teach him self- 
reliance and the importance of speaking the truth. 
Do not drive him, and when you promise him any- 
thing, see that he gets it, whether it is a penny or 
a whipping. Never deceive a child, and above all 
never frighten one. Parents ought to be ashamed 
in this generation to talk to children about a "bogy 
man." See that the child sleeps peacefully and 
naturally. If it cannot sleep with its mouth closed, 
call a physician at once and see if it has adenoids, 
and if so have them immediately removed. Your 
children, like Cornelia's, are your jewels and you 
should treasure them as you would so many per- 
fectly matched pearls, for they are more precious 
than the finest gems that ever came from the mystic 
caves of ocean, and their little lives are more po- 
tential for good than all the colleges of Christen- 
dom. They are the future workingmen and work- 
ingwomen of America; the toilers who are to ex- 



184 THE WORKING PEOPLE: THEIR HEALTH 

tend and preserve the civilization that we enjoy, 
and that they under God will render yet more 
beautiful and beneficent. 

Teach your child cleanliness as early as you teach 
it to be virtuous and brave. Watch its little mouth 
and its first teeth. Teach it as soon as possible 
that care of the teeth is absolutely necessary if it 
would keep well. Tell it that disease germs lurk 
in an unclean mouth and that it is as necessary to 
cleanse the teeth as it is to cleanse the face. Give 
the child its own tooth-brush and renew it at fre- 
quent intervals. But do not rely upon a tooth- 
brush alone. An excellent mouth-wash like Diox- 
ogen should be used frequently. No matter what 
your circumstances are, you are not too poor to 
keep clean, and keeping the mouth clean is abso- 
lutely essential to the physical welfare of the work- 
ing people of this country. If you pay no atten- 
tion to anything else I say in this book and will 
bear this fact in mind, you will have taken a long 
step towards preserving your bodily health and 
that of the little one God has given you. Don't 
neglect your teeth. Don't neglect their teeth. 
Keep them clean as you value their life. Keep your 
own clean if you want to live. 

Give your child plenty of fresh air at night as 
well as in the daytime. Don't shut yourself up 
at night in a hot, stifling room. Don't sleep in the 
same room with your child if you' can help it, but 
if you have to, see that as much fresh air as pos- 
sible gets into the apartment. Remember foul air 
kills and fresh air makes alive, and if you want 
to live, open your windows at night. Of course, 



AND HOW TO PROTECT IT. 185 

I do not mean for you or the child to sleep directly 
in a draught, but do not fear the presence of fresh 
air in your sleeping chamber. Let the little one 
go bare-footed in summer and keep its feet dry 
and warm in winter. I once heard of an old chap 
who, when asked his creed, replied whimsically, 
"Do unto others as you would have them do to 
you; be honest and clever and I swear you'll be 
saved." In the same way, if you would keep your 
child's teeth clean, his lungs filled with pure air 
and his stomach nourished with plain and whole- 
some food, I affirm his body will be saved and 
strong, healthy manhood or womanhood assured. 

Psychologists, and all who have much to do with 
child nature, realizing the advantages of outdoor 
life for the growing youngster, have endorsed un- 
hesitatingly the open-air school and it is one of the 
movements that promise untold blessings to the 
coming generation. One of the sturdiest Celts I 
ever knew, a man who lived to be fully 80 years 
of age, was educated in the hedge schools of Ire- 
land, and thousands of sturdy peasants in that 
bonny green isle obtained their only instruction 
under its beautiful trees. Germany's forest schools 
are the pride of the empire, and America is only 
waking up to the possibilities of these outdoor 
schools. 



186 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXXI 
Spitting and its Dangers 

The first thing" that attracts one's attention as 
one enters the grounds of a sanatorium or properly- 
conducted hospital, is the entire absence of spittle 
of any kind, and as soon as a patient is encountered 
one observes he is carrying a sputum box around 
with him. This reason is plain. Tuberculosis is 
dangerous only when people having it are careless 
about their sputum, for in the spit lie the germs. 
As soon as the sputum becomes dry the germs are 
released and can then be blown about or carried 
upon the clothing almost any distance, and when 
these small particles are inhaled, infection may fol- 
low. Happily, as I write, many states are putting 
into operation laws making it a crime to expecto- 
rate promiscuously, either in public or private 
places. 

One large manufacturing plant in my health dis- 
trict will not hire a man who chews tobacco, for 
they say he must spit, and not only may infect, but 
they will not tolerate this filthy habit. Dr. Flick 
says no one in health spits, except when he gets 
something nasty in the mouth, such as an insect 
or tobacco. Many people get into the habit of 
spitting and of so wasting the saliva, which is in- 
tended to keep the mouth clean. 



j 



AND HOW TO PROTECT IT. 187 

Not only are the bacilli of tuberculosis spread by 
spitting, but the germs of pneumonia and of tonsili- 
tis are spread in the same way. You may always 
notice after a dry spell, and after the wind has 
stirred up the germs in spreading them about in the 
air, that our epidemics of tonsilitis occur. These 
germs have been taken in through the nasal pas- 
sages or through the mouth, and then located upon 
the tonsils, where they set up little ulcers called 
follicles, or follicular tonsilitis. These are little 
white ulcers which appear as small spots upon the 
tonsil or tonsilar tissue. 

Again, if one spits promiscuously, he may infect 
a member of his family unconsciously. Many per- 
sons have tuberculosis without even knowing it. 
It has been said that 80 per cent, of all persons 
have tuberculosis, either latent or active ; I mean by 
this many have tuberculosis without the symptoms 
except the cough. If persons who have what they 
term a hard cold are careless about their spittle, 
they may unconsciously infect other members of 
the household. The sputum of many a person hav- 
ing a bad cold has been found upon examination to 
contain the bacilli of tuberculosis. 

A person may have typhoid fever not knowing 
it, be a carrier and infect many other people. The 
promiscuous habit of spitting in smoking-cars can, 
during the year, infect many persons with tuber- 
culosis. Every smoking-car should have proper 
receptacles for expectoration partially filled with a 
strong disinfecting fluid and should enforce the law 
to the letter. Many of our "smokers" today are 
veritable hot-beds for the dissemination of disease. 



188 THE WORKING PEOPLE: THEIR HEALTH 

In many cases they are overheated, poorly venti- 
lated, carelessly looked after, and afford just the 
right place for germs to breed in. It is my opinion 
that up to the present time we are not sure just 
how many kinds of disease are present in the 
spittle, for we do not examine it until we look for 
disease because a person has fallen ill. I want to 
see the time when the question of spitting will re- 
ceive more careful attention from the masses, when 
they will not only stop spitting because it is a 
filthy habit, but because the time will come when 
they will realize that they may unconsciously infect 
innocent persons. 

A short time ago a man came to me with the 
story of his wife having died of consumption after 
having been sick only three months. He came to 
me with the history of having been treated for 
stomach trouble for eighteen months. He said that 
he had a hard cough all this time and that he did 
raise considerably, and was not careful of what he 
did raise. The history of his case after an exam- 
ination of his sputum, finding it loaded with bacilli, 
led me to believe that this man infected his wife 
because he stated that he had always "spit any- 
where he felt like," and was not careful. 

When municipalities and states rigidly enforce 
the laws relative to spitting, when all owners of 
public buildings, through their agents, do the same, 
when all railroad companies make this spitting act 
punishable by arrest and fine, when owners of fac- 
tories and stores live up to the law, — then Con- 
sumption will have received a death-blow! 



AND HOW TO PROTECT IT. 189 



CHAPTER XXXII 

Nervousness, its Causes and its Prevention 

The American people are fast becoming a nation 
of neurasthenics. By this term, I mean that ner- 
vousness as a disease is not only alarmingly prev- 
alent, but that it is sapping the vitality of the pres- 
ent generation at a rate that astonishes the inves- 
tigator, and its influence on the coming generation 
must, in the ordinary course of events, be trans- 
mitted. 

In 500 cases coming to my office for treatment 
in the last five years, 408 being women and 92 men, 
450 showed signs of nervousness in some form. Of 
these 210 were mothers, 200 were unmarried and 
ninety were men (65 single and 25 married). If 
the average practitioner will stop to make note of 
the condition of the people he is called upon to 
treat, he will be amazed at the percentage of ner- 
vous wrecks. It is more prevalent in the young 
and those of middle age than in those of advanced 
years. Modern nervousness is the most common 
of all diseases, and unless checked must leave its 
mark upon the offspring of the present generation. 

WHAT CAUSES NERVOUSNESS? 

In an analysis of the cases enumerated above, in 
100 cases it was caused by an insufficient amount of 



190 THE WORKING PEOPLE: THEIR HEALTH 

rest; in 51 cases it was due to indiscretion in diet; 
in 30 cases, lack of proper exercise; in 34 cases, 
lack of proper amount of fresh air; in 25 cases by 
the use of alcoholic stimulants. 

HOW CAN IT BE AVOIDED? 

First of all, not by the use of drugs, not by the use 
of artificial stimulants, but by applying system to 
our lives. Our forefathers were not nervous, be- 
cause they lived under a system, because they had 
regular hours for retiring, because they were fond 
of walking, because they took little or no medicine, 
because they lived on plain and simple food, prop- 
erly cooked. Overdressing and impure air deprive 
the vital organs of the opportunity of doing their 
work. The inactivity of the bowels and kidneys 
results from improper food, water and air. Worry, 
too, was eliminated from our grandfather's list. They 
did not have our present school system with all its 
fads and follies to contend with; they were obliged 
to take proper and systematic exercise. The aver- 
age physician is nervous because he does the very 
things he tells his patient not to do, because he 
is a transgressor when it comes to a question of 
diet, exercise and fresh air. 

EATING WHEN TIRED 

This is one of the most common causes of ner- 
vousness. The stomach is a muscle, and food is 
digested by a churning motion and by the proper 



AND HOW TO PROTECT IT. 191 

elimination of the gastric juices, but when they are 
not working properly — and they will not when the 
system is tired — undigested food becomes a poison 
to the general system. The wearing of too many 
clothes causes weakness and consequently nervous- 
ness. The skin is the most vital part of our 
anatomy. Why? Because, when unencumbered by 
too much clothing, it carries off waste and poison- 
ous materials. This poison, unable to escape 
through the skin, is thrown upon some other organ 
which has already a duty to perform. 

SUMMARY 

Overcrowded curriculum in our public schools; 
alcoholic stimulants; impure air; overeating; the 
drinking of too little water; insufficient amount of 
rest; overdressing; constipation; faulty mental 
attitudes called "worry;" improper bathing; lack 
of proper and systematic exercise. 

These are the prime causes of nervousness, and 
with few exceptions, these can all be avoided if a 
judicious use is made of the mental faculties. In 
other words, if we wish for healthy babies, if we 
wish for healthy offspring, we must get back to a 
simple life. What we want is healthy offspring, 
not tubercular. Instead of sanitariums, a proper 
working day both for the mother and father, ab- 
stinence from all forms of dissipation, regular 
exercise and freedom from worry are what we need 
to prevent the weakened muscular system and 
weakened mentality, we dub "nervousness." 



192 THE WORKING PEOPLE : THEIR HEALTH 



CHAPTER XXXIII 

Diphtheria — What Causes it? What 
Prevents it? 

Nothing strikes terror so quickly to the heart of 
a father as to learn that his child has diphtheria, 
but the danger is not in learning this fact, it is 
rather in neglecting to learn where the danger lies. 
Why is this true? For several reasons; first and 
foremost is that an unrecognized case of diphtheria 
is capable of infecting other children in the family 
and neighborhood. Many a child has lost his life 
from diphtheria and the mother has said after his 
death, "Oh, he played with the little boy across the 
street who had a sore throat, but he wasn't sick." 

Now, first of all, I want to say that diphtheria 
is one of the most deceptive diseases and many 
times cannot be told until a culture is taken. It 
may be treated for a simple sore throat or a simple 
cold, and just here is where the danger lies. For 
in a mild case in the beginning the child may 
simply suffer from a little stiffness of the neck with 
the ordinary symptoms of a cold, perhaps not even 
fever to start with, and swallowing is not interfered 
with to any great extent, but — there is one point 
sometimes overlooked, even by the physicians, and 
that is this — always look into the throat! 



AND HOW TO PROTECT IT. 193 

If the child seems tired, shows no desire to play, 
complains of chilly sensations, says the neck is 
stiff or aches, look at the throat. If in addition to 
the above symptoms the throat seems red and in- 
flamed, put the child at once by itself and call a 
physician. Don't think you cannot afford to do 
this ; you cannot afford to neglect it, first for your 
child's sake and second for the sake of the brother 
and sister and for the neighborhood. In these days 
there is no excuse for neglect, for any physician 
will be glad to make the culture for you. Isolate 
at once, call a physician, and follow his directions 
minutely and you have half the battle won. The 
treatment of diphtheria, today, is anti-toxin. If the 
case is mild the simple using of this agent, followed 
by careful nursing, is the whole treatment. If the 
case is severe, there is no place quite so gjood as 
the Isolation Hospital, where nurses experienced in 
this work are readily at hand as well as compe- 
tent physicians. Many a child's life has been saved 
by the prompt act of putting a tube in the child's 
throat, that it may have space to breathe. 

This disease has been robbed of many of its 
terrors since the discovery of anti-toxin, and since 
1880, when Dr. Joseph O. Dwyer began the use 
of instruments called intubation instruments. The 
life of many a child has been saved by being given 
a place to breathe, otherwise it must have 
strangled. I have always felt that - Dr. Dwyer 
rendered to humanity one of the greatest bless- 
ings ever transmitted. It is hard enough to see a 
little child die naturally, but it is an awful spectacle 
to see it strangle to death. I am glad to say that 

13 



194 THE WORKING PEOPLE: THEIR HEALTH 

I have not been obliged to witness such a spectacle, 
for when I became a physician his discovery was 
being put into use by many physicians. 



NOW AS TO ITS CAUSES 

The question of just where diphtheria originates 
has never been absolutely settled, but studies of 
epidemics have shown to my satisfaction that it 
is a disease of filth and filthy surroundings. Where 
there have been a number of cases in any one city 
or town, it is always in the poorer sections it claims 
most of its victims. And while the most robust 
child may be attacked, it spends its fury among 
those with poor housing facilities and whose nu- 
trition is none too good. Here again the question 
of sunlight, plenty of fresh air, plenty of simple 
food, cleanliness, not only of the house but of the 
body, are the most prominent features to carry out. 

Remember, the disease is contagious. Do not 
let a child kiss you or kiss another with a sore 
throat. Place him by himself in a room, do not 
take his breath, be careful about his cough, lest he 
cough into the face of you or others. Let him have 
only his own drinking-cup and towels. Look for 
the disease often in the fall and winter months. If 
you hear of its breaking out in a school-room, keep 
your children from school for a couple of weeks. 
If you learn of its being in the neighborhood, try 
and learn from whom the people suffering from it 
are taking their milk, and if you are satisfied that 
several families have it and are taking their milk 
of one milkman, report same to local board of 






AND HOW TO PROTECT IT. 195 

health at once, asking for an examination of this 
milk; and if the local board of health does not stop 
the sale of the milk, you stop the sale of it at your 
house for six weeks at least. 

In closing, I want to say again that it is a de- 
ceptive disease, and that whenever any departure 
from normal health is noticed, have a culture made 
of your child's throat, particularly if it be in the 
seasons of which I have spoken, remembering that 
if taken early it can be easily cured, but if let alone 
it is a dangerous, poisonous disease which, if event- 
ually cured, leaves the patient many times an 
invalid for the rest of his life. 



196 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXXIV 

Care of the Child from Birth until the Four- 
teenth Year 

As soon as the first child is born the responsi- 
bilities of a mother begin. Since time began it has 
always brought about immediate anxiety which did 
not exist previous to the time when this precious 
burden was placed in the hands of the parents. 
Someone has called them "troublesome comforts," 
some one, "old-fashioned things." A well-known 
physician of London was chided by the mother 
because to her his ideas seemed old-fashioned, to 
which he replied, "Well, lady, babies are old- 
fashioned things anyhow." 

Among the rich and well-to-do a large share of 
the anxiety that falls to> the lot of the common 
people is absent. The wife of a wealthy man who 
had been a mother for seven months told me she 
had seen baby but eight times in this period; but 
the average mother rarely ever has baby out of her 
sight until the second year is reached. For years 
infant mortality has been of serious concern, not 
only to the parents, but to municipalities, govern- 
ments, philanthropists, sanitarians and social 
workers. It is only within recent years, however, 
that the great mass of people have awakened to the 



AND HOW TO PROTECT IT. 197 

fact that hundreds of thousands of infants are 
dying needlessly each year. 

It is said on good authority that 375,000 children 
in this country perish during the first year of life. 
In 1908, in New York city, 16,230 infants died dur- 
ing the first year. 

The lives of hundreds of infants are offered 
up each year because Dame Fashion decrees that 
it is not fashionable to nurse a child. Mothers, I 
want to say to you, whenever your health permits, 
do your duty toward your child and bring him up 
as nature intended you should. Chapter after 
chapter has been written upon the preparation of 
babies' food, but I have yet to find in any medical 
book a chapter devoted to arguments showing why 
the mother should nurse her child. There has 
never been a food, there never will be a food, that 
can take the place of the milk coming from the 
breast of a healthy mother, and again, the vital and 
mental forces of a child reared on artificial food 
will never reach the degree of development that 
will compare with the baby fed at the breast. Some 
of the energy now being expended upon the pure 
milk problem would bear more fruit if it was spent 
in teaching the mother how to maintain her bodily 
health and why it is essential she should do so. 
Attention to the matter of cleanliness, bathing, eat- 
ing, sleeping, rest and sunshine, and a little more 
maternal affection, would reduce the infant mortality 
one-half in the next decade. However, I am not 
writing a treatise on diseases of children, but my 
aim is to lay down a few simple rules; first, to the 
mother while she is carrying the child and, second, 



198 THE WORKING PEOPLE : THEIR HEALTH 

as I have indicated, the care of the child from birth 
until the fourteenth year. 

THE PREGNANT WOMAN 

First of all, avoid all excesses, avoid getting over- 
tired. Take the fifteen minutes noonday rest if 
more cannot be obtained. Try, under all circum- 
stances, to avoid excitement of any kind. Pay 
especial attention to the diet; do not overeat. Fol- 
low out religiously the axiom of proper exercise, 
walk a good deal and bathe properly. The chapter 
in this book on bathing will give you ample in- 
struction along this line. Avoid constipation, hold 
your temper at all times, and get all the fresh air, 
both day and night, that you can. Sleep in a room 
by yourself whenever you can. Avoid looking at 
all unpleasant things; attend as many musical en- 
tertainments as possible; choose congenial and 
jovial companions. Avoid all visits to the sick, to 
hospitals, to friends who are unfortunate; remem- 
ber that the temperament of a generation to come 
is in your hands; let the dead past bury the dead. 

CARE OF THE CHILD 

The proper way to bathe a child is the first thing 
a mother should know; many so-called nurses have 
yet to learn this art. Immediately after birth, a 
child should be given a full bath, and for this reason 
the so-called foot-tub should always be at hand. 
Have your water at 94 degrees or 95 degrees; 
always test with a thermometer. A nurse who can- 



AND HOW TO PROTECT IT. 199 

not use a thermometer ought never to be allowed 
in the room of a woman who has borne a child. 
Wash the little one quickly, leaving in the bath 
but four minutes ; when taken out rub briskly ; have 
the room at 75 degrees, or even warmer if possible ; 
dress quickly and roll in a woolen blanket. In 
washing, particular attention should be paid to 
the eyes; they should be washed thoroughly with 
tepid water and watched carefully. Ask the nurse 
to have the physician look at baby's eyes at each 
visit. 

Especial attention should be paid to the mouth. 
Sometimes it is covered with whites, which is 
known as thrush, and this can be easily removed by 
using a weak solution of peroxide of hydrogen, one- 
half teaspoonful to a cup of water. Wash care- 
fully several times a day. In bathing] the child 
avoid strong soaps and too vigorous rubbing, either 
during or after the bath. If the skin appears to be 
sensitive and chafing is easily produced, use plenty 
of one of the dusting powders. Extreme care 
should be taken of the buttocks; this is a common 
place for chafing, as the parts are often soiled, there- 
fore great pains should be taken that all napkins 
be removed as soon as they are soiled and the parts 
kept clean and dry. If the parts should become 
chafed, bathe with a little sea-salt and water. Mus- 
lin or linen should be worn next to the skin. 

The child should not be dressed too warmly; the 
chest is best covered with Canton flannel, and the 
abdomen supported by a flannel band which should 
be pinned not too tightly. In perfectly healthy 
infants this band may be replaced after three 



200 THE WORKING PEOPLE: THEIR HEALTH 

months by a cotton band. During the extremely- 
hot weather, dress the child lightly, do not over- 
burden it with heavy clothing. This is one of the 
most common errors in the care of a child. Always 
avoid heavy clothing while in the house: children 
are naturally warm-blooded, and for this reason 
their blood easily becomes overheated while at play. 
While in the street they should be protected with 
warm clothing and the feet should always be kept 
dry. 

Use as large a room as possible for the nursery 
and have it well ventilated ; the more sunshine you 
have, the better. The temperature of this room is 
best at 66 or 68 degrees ; never should the ther- 
mometer be allowed to go over 75 degrees. During 
the night in the first three months it should not 
go below 64 degrees ; after this time it may go as 
low even as 50 degrees, providing draughts of all 
kinds are avoided. The nursery, or room in which 
the child is kept, should be thoroughly aired at 
least three times a day. If the room is kept too 
warm it at once begins to tell upon the general 
health of the child. It often becomes pale, stops 
gaining weight, takes cold easily. These condi- 
tions readily lead up to a rapid, serious illness. 

I would always take a child, in the spring of the 
year and in the fall, into the open air after it is 
five weeks old. In summertime it may be taken 
out any time after the second week.- Airing of the 
room should begin when the child is six weeks old, 
and at two months it may be taken out on pleasant 
days if kept in the sun. Sharp winds and extremely 
cold weather when the ground is covered with 



AND HOW TO PROTECT IT. 201 

snow and slush should not be chosen as days for 
airing the baby. When placed in the carriage see 
that it is properly protected from draughts and 
that the sun is not allowed to shine directly into 
the baby's eyes. Some children take cold upon the 
slightest provocation; they are better kept in cool 
rooms and especially when they are sleeping. They 
should not be covered too warm so as to cause 
perspiration. Every morning I would bathe the 
chest and spine with cold water at about 65 degrees 
Fahrenheit. In giving this bath the child may 
stand in a tub containing warm water, and the body 
should be gone over thoroughly with a soft towel 
or linen, using a temperature of water at about 70 
degrees. 

Children are often nursed or fed too often. I 
would not allow a child to be fed either at the breast 
or from the bottle oftener than once in two hours, 
and I would not allow him to nurse when at the 
breast over fifteen minutes at each nursing. Place 
him first at one breast and then at the other. The 
nipples should be kept clean and should be washed 
after each nursing. The mother should drink 
plenty of liquid food and should eat nourishing 
food, including meat, vegetables and fruit, ordi- 
narily no wine or beer. 

Avoid getting nervous, avoid fatigue or passion, 
for these easily tell upon a child. A perfectly 
healthy child should sleep from one to two hours 
after each nursing. If in nursing the child, or if in 
bringing it up on the so-called bottle it does not 
gain in weight, sleeps irregularly and suffers from 
colic and the movements contain undigested food, 



202 THE WORKING PEOPLE: THEIR HEALTH 

it is a pretty sure sign that its nourishment is not 
agreeing with it. The question is often asked, ''Can 
I nurse a child and feed it at the same time?" 
There is no objection to this providing it is fed 
through the night to allow the mother to get her 
sleep. 

The question of weaning a child is a much- 
mooted question. Some authorities believe that the 
ninth or tenth month is the proper time. Person- 
ally, I believe that when the mother is well and 
strong and the child seems to be doing well, it is 
better to nurse it over the second summer. This, 
however, should be left entirely with the physician 
in charge. As I said in the beginning there is no 
food that takes the place of mother's milk, and 
whenever it is possible and the health of the 
mother seems not to suffer, she and the child are 
better off when the child is nursed. When it be- 
comes necessary, by reason of ill health or some 
unforeseen reason, to remove the child entirely 
from the breast, the choice of food becomes a very 
delicate question. Today there are many excellent 
foods and numerous formulas for every preparation. 
I think, however, it is always well to consult your 
physician whenever it seems necessary to use a 
substitute for mother's milk. 

Whenever cow's milk is used it should be steril- 
ized. This is best done by using an Arnold steril- 
izer and following out the instructions given with 
each one of these apparatus. Each bottle, as fast 
as it is emptied, should be thoroughly washed in 
hot soap-suds and water and then placed for ten 
minutes in boiling water. As for the choice in 



AND HOW TO PROTECT IT. 203 

nipples, I prefer a straight nipple that slips over 
the neck of the bottle. The nipples should be kept, 
while not in use, in a solution of borax and care- 
fully washed with boiling water four or five times 
a day, particularly in the warm weather. As I 
said before, during the first month the child should 
not be fed oftener than once in two hours and about 
three times during the night. This regularity gets 
the child into a habit of sleeping at regular inter- 
vals, and when the child appears to be resting do 
not awaken it to give it its food. 

Whenever the child takes the nourishment from 
the bottle very quickly and cries when it is taken 
away, then we have good reason to believe that 
the child is not getting proper nourishment. After 
the eleventh month the child may be fed a little 
in addition to its milk or prepared food. A little 
beef-juice and the whites of eggs seem always in 
my hands to be satisfactory. After a child is three 
years of age it had better be kept on five meals a 
day. The question is often asked, "What should 
be the hours for feeding at this period of life?" 
This depends absolutely upon circumstances. I 
should say, however, that it might be fed, if it is 
awake, at 6 a.m., at 9.30 a.m., at 1.30 p.m., 4.30 p.m., 
and at 7.30 p.m. "What should it be fed at these 
meals?" is often asked. The diet should be simple. 
Cereals, oatmeal, rice and hominy may be given. 
I have seen, however, perfectly healthy children 
who seem to eat nearly everything and it does not 
seem to hurt them. In other words, with the child 
as with the adult, every stomach is a law unto itself. 

During the third or fourth year the diet should 



204 THE WORKING PEOPLE : THEIR HEALTH 

still be simple. Half of an orange may be given, 
and oatmeal. Milk may be given freely, small 
pieces of steak and chicken, and potatoes. Avoid 
giving the child fresh bread, and I believe that 
bananas are the cause of more spasms than any 
other one thing. I would avoid giving a child dried 
beef, fried liver or bacon and the dressings from 
different roasts, because these are generally too 
rich. If potatoes are given they should always be 
roasted. Celery may be given. Green corn at this 
age I would avoid. I would not give hot bread, 
buckwheat or griddle cakes, and I would avoid 
pastries as far as possible. Candies, fruits and pre- 
served fruits, tea and coffee, I would avoid. 

Begin by teaching your child to take plenty of 
time to eat, for this is one of the most important 
things which he should be taught. In all acute ill- 
nesses, such as fever, severe colds, or in very hot 
weather whenever the slightest indisposition is no- 
ticed in the condition of the child, it is well to with- 
hold all food for a period of five or six hours, that 
the stomach may be able to empty itself thoroughly. 
The child's bowels should always be watched, 
and a healthy child after the second or third year 
should have three or four stools each day. 

Sometimes the question is asked, "Should the 
child sleep in the same bed with its mother?" I 
would say that whenever this can be avoided, No! 
The child's bed should be a mattress, never a 
feather bed, and whenever possible hair pillows 
should be used instead of feathers. When the 
child is put to sleep the room should be darkened, 
and after it has been fed, it should be placed in the 



AND HOW TO PROTECT IT. 205 

quietest room possible with plenty of air, with the 
windows open, being careful to avoid draughts. 
Weak, sickly and nervous children get along finely 
when they are allowed to sleep on the piazza or 
out of doors, and always when possible in the yard, 
when the proper shade can be obtained. The child 
never sleeps too much except when it is severely 
ill, or except when given such things as soothing 
syrups which contain opiates. 

Wheji children begin teething they are very often 
fretful and their sleep is poor. They may lose their 
appetite and there is salivation and drooling, and 
sometimes they may have fever; there may be 
nausea and vomiting, with food in the stools which 
has not been digested. All these symptoms differ 
in different children with different temperaments. 
I have known a child to cut from twelve to four- 
teen teeth without the least disturbance. I have 
known another, upon the advent of the first tooth, 
to have fever, restlessness, vomiting and indigestion. 

As soon as the child arrives at the age of ten 
months, then I would allow it to sit alone, but 
great care must be exercised, that the child may 
not commence to walk too early. If this is allowed 
it brings about a bending or crooked condition of 
the limbs, a condition known as bow-legged. 

If for any reason, either by overeating or from 
any cause, the child should have a convulsion, 
before the physician arrives, place the child at once 
in a warm bath and then roll it in a large towel 
which has been dipped in mustard and water, one 
heaping tablespoonful of mustard to two quarts of 
^warm water. Colic is a condition which comes on 



206 THE WORKING PEOPLE : THEIR HEALTH 

suddenly and there is drawing up of the feet and 
the abdomen is usually tense and hard. In this 
case it is always well to give an injection; if the 
child is four years of age, say a teacupful of warm 
water to which fifteen drops of turpentine have been 
added. Then apply to the abdomen an allspice 
poultice, which is made by using a quarter of a 
pound of allspice mixed with hot water, the same 
as when you mix a mustard paste, putting this 
between cheesecloth or old linen and applying it 
across the abdomen. I would then give twenty-five 
drops of elixir catnip and fennel in four teaspoon- 
fuls of hot water. 

Ofttimes a child will cry from earache. The 
pain in this case is usually very severe and the 
child will often place the hand to the ear. In this 
case it is always well to have a few drops prescribed 
by your physician in the house, that you may drop 
into the ear. Hot poultices or a hot-water bag may 
always be tried. Often the child will awaken sud- 
denly in the night with a barking cough and it 
appears difficult for it to get its breath. This is 
usually simple croup. It is not dangerous and can 
often be relieved at once by application of cloths 
wrung out in cold water and wrapped around the 
throat. An old remedy and one which is helpful 
is to give fifteen drops of syrup of ipecac every 
fifteen minutes until free vomiting occurs. 

The question of contagious diseases among chil- 
dren I shall not touch upon in this chapter, for I 
have taken them up separately in this work under 
separate headings. Their onset does not differ ma- 
terially in the child from that in the adult. 



AND HOW TO PROTECT IT. 207 

All through the life of the child there is a ten- 
dency upon the part of parents to spoil the child 
by humoring him, allowing him to have those 
things which they know are not good for him to 
eat or to drink. Careful attention to the child's 
diet, careful attention to his sleeping-room and to 
his bathing, plenty of plain and simple food and 
proper exercise, systematically and judiciously car- 
ried out, all tend toward building a healthy con- 
stitution and a rugged body. It is very easy to 
spoil a child by allowing him to have his own way, 
and the old axiom, "Spare the rod and spoil the 
child," applies in nearly every case. I would com- 
mence with the child, whether it be a boy or girl, at 
the age of eight years. I would teach him or her 
the importance of breathing properly, the impor- 
tance of learning to sleep with the mouth closed. 
If the child cannot sleep peaceably with the mouth 
closed, then there is usually some obstruction which 
should be looked to and removed. Teach the child 
to walk properly and to stand erect, and each day 
to carry out a systematic method of lung baths ; 
this is done by having the child stand erect in a 
room where the windows are open, closing the lips 
tightly and drawing in the breath until the lungs 
are thoroughly filled, then allowing it to escape 
through the nose. Take three or four ordinary 
breaths and then repeat in the same manner as 
before, repeating this exercise from three to five 
times each morning. I would early teach the child 
simple exercises with the dumb-bells. Both boy 
and girl, after they have reached the age of ten years, 



208 THE WORKING PEOPLE: THEIR HEALTH 

should be taught how to swim and how to row, 
and whenever the circumstances permit, how to 
ride horseback. They should be taught how to 
walk properly, and whenever it is consistent with 
the circumstances of the family, at twelve years 
of age they should be placed in a gymnasium. 

There are in the lining, particularly at the upper 
part known as the apex of the lung, a large number 
of unused cells which the air never reaches unless 
proper and systematic breathing exercises are car- 
ried out. I would watch for any lumps in the side 
of the neck, and whenever these make their appear- 
ance I would consult my physician. If there is 
any obstruction whatever to free and natural 
breathing, always have the child's nose examined 
for adenoid growths; for large tonsils and adenoid 
growths are the easiest spots for the bacilli of tu- 
berculosis to lodge, as well as the germs of many 
other diseases to which the child is subjected. 

Teach the child early to be self-reliant. The ex- 
pression that a boy of twelve years is a "little man" 
is one of which you should be justly proud. Self- 
reliance must be early taught to the child, be it boy 
or girl. If taken early it is easy to acquire as the 
years go on. If you start a child at eight teaching 
him to rely upon himself in the question of eating, 
drinking, bathing, breathing and exercise, by the 
time he reaches his fourteenth year he will have 
formed a habit which it will be very easy to carry 
out as the years go on. There is no need of the 
narrow chests and the stooping shoulders and the 
slouchy gait so often noticed in the children born 



AND HOW TO PROTECT IT. 



209 



both in the city and in the country. All these 
things are products of bad habits formed in early 
childhood and allowed to continue as the years 
go on. 



210 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXXV 

Scarlet Fever a Dangerous Disease, and how 
to Prevent it 

In few diseases are preventive measures as 
easily carried out as in scarlet fever. Because this 
disease is so dangerous, because it has so many 
complications, because it leaves in its wake so many 
permanent injuries, it is of the utmost importance 
that it should be prevented whenever possible. 
The most important measure in the prevention of 
scarlet fever is the isolation of the sick. The isola- 
tion should be absolute and should apply to nurse 
as well as to the sick child. A room in which this 
can be accomplished most perfectly should be 
selected. All hangings, draperies and unnecessary 
furniture should be removed. One person should 
be selected to communicate between the nurse and 
family. Many a child has lost his hearing and 
gone through life a cripple, simply because care 
was not exercised. It is criminal to keep a case 
of scarlet fever and not report it to the Board of 
Health. I shall point out in this chapter some of 
the complications of this disease and the reason 
why the sick, rich and poor alike, should exercise 
the utmost precaution in this dreaded disease. 
Whenever practical all cases should be sent at once 
to the isolation hospital. It is a preventive dis- 



AND HOW TO PROTECT IT. 2 II 

ease and one that means much to the workingman. 
It is particularly dangerous when contracted by an 
adult. It is the plain duty of your family physician 
to point out these facts to you. 

The doctor's visits should be as short as are con- 
sistent with good treatment. He should never enter 
a sick-room and then mingle with other members 
of the family. The period of isolation should not 
be less than forty days, and much longer if peeling 
continues. Upon giving up quarantine, the child 
should be thoroughly bathed with soap and water, 
and then with a solution of corrosive sublimate, 
one to five thousand. One gallon of this can be 
obtained in a drug store for ten cents. 

No carpets should be left in the room, and those 
removed should be thoroughly disinfected with 
boiling water or steam. The mattress used should 
be at once destroyed. The room should be 
thoroughly washed, floor, ceiling and walls. It is 
certainly your duty to listen to the instructions 
which should be minutely given by your physician. 
The death rate from scarlet fever can easily be 
reduced one-half in the next ten years if your fam- 
ily physician, yourself and the local Board of Health 
cooperate. 

The complications of scarlet fever which are 
most likely to occur, and which first make their 
appearance, are a disturbance with the kidney. 
Often, when the fever is at its height, traces of 
albumin may be found in the urine. Kidney affec- 
tions are most common, however, in the second or 
third week. And they may develop after a very 
mild attack. I have found that when they develop 



212 THE WORKING PEOPLE: THEIR HEALTH 

in the second week they are apt to be serious. The 
urine is apt to be suppressed, a small quantity may 
be passed, which is dark and bloody, laden with 
albumin and tube-casts. Vomiting is constant. 
Convulsions usually occur and the child may die 
with symptoms of acute uraemia. 

Sometimes the symptoms are not so severe. 
There is a puffy appearance of the eye-lids with 
slight swelling of the feet. These cases may drag 
on and become chronic, or the patient may succumb 
to ursemic accidents. 

EAR COMPLICATIONS 

These are common and ofttimes serious. They 
are due to the extension of the inflammation from 
the throat through the eustachian tubes. This is 
a most frequent cause of deafness. In other in- 
stances there is suppuration or pus formation in 
mastoid cell. Sometimes, even, abscess of the 
brain may follow these complications. 

HEART COMPLICATIONS 

Simple endocarditis is not uncommon, and many 
cases of chronic valvular disease originate probably 
in the latent endocarditis during this disease. 

ADNITIS 

In very mild cases of scarlet fever, many of the 
glands of the neck may be swollen. Acute inflam- 
mation may occur, leading to widespread destruc- 
tion of tissue, and fatal hemorrhage may ensue. 



AND HOW TO PROTECT IT. 213 

CHOREA, OR ST. VITUS' DANCE 



may develop as a complication. Sudden convul- 
sions may occur; even paralysis with a wasting of 
the limbs may appear as a result of these nervous 
symptoms. 

I only mention the complications and the dangers 
of this disease, that the parent may understand fully 
that it is a disease that needs the watchful care 
and advice of a physician. A great mistake is often 
made in trying to treat these cases yourself. Be- 
cause the child does not appear to be very sick is 
no reason why you should try to treat the case 
yourself. Sometimes an apparently mild case may 
develop all the symptoms which I have mentioned 
above, and because of your neglect to call medical 
aid, your child may go through life with his hear- 
ing permanently impaired and a kidney damaged 
beyond repair. Much of the heart disease found in 
children can be traced to a mild untreated case. 



214 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXXVI 

Breathing Exercises and their Value to 
Health 

All muscular exercise is followed by an increase 
in the ventilation of the lungs. Of the many people 
who are particular to bathe each day, how com- 
paratively few pay any attention to lung baths or 
breathing exercises. A working muscle needs a 
larger quantity of oxygen, and this should be in 
proportion to the amount of use it receives, and as 
the lung is constantly active it requires a large 
amount of oxygen. This not only carries nutrition 
to the blood, but it takes away carbon dioxide more 
freely, which is a poison to the general system. 

If there is one law of health which has been 
established at the. present day, this is the law be- 
yond question: There are in the normal lung a 
large number of cells known as reserve cells. 
These cells are seldom used by the average person, 
because very few breathing exercises are taken. It 
is my opinion that pulmonary gymnastics, breath- 
ing exercises, will have to be taught, not only to 
individuals, but such teaching must eventually form 
a part of our school curriculum. I would especially 
impress upon every reader of this chapter at least 
to give these few principles a careful and system- 
atic trial. The results for good to his or her gen- 
eral health will soon be apparent. 



AND HOW TO PROTECT IT. 215 

People who neglect to take proper and system- 
atic exercises in breathing deprive their system 
of the most important element in its nutrition. 
Oxygen, fresh air, carried into the lungs, deposits 
oxygen in the blood, building up the red blood 
corpuscles that carry strength to every part of the 
body. The breath is the life. Without food a man 
may live forty to seventy days, without fluids he 
can live several days, without air he will die in a 
few minutes. The more we breathe, properly ex- 
panding every portion of the lungs, the more oxy- 
gen we inhale; the more oxygen, the more life. 
The men at the top are almost always the big- 
chested ones. The greatest men of all times, states- 
men and warriors, were all deep breathers ; here we 
have Napoleon, Webster, Gladstone and Brooks. 

What does proper breathing do? It increases the 
nutrition of the body, it increases the elimination 
of waste products. An immense amount of energy 
and endurance is brought about because the poison- 
ous gases are properly carried off, and because nu- 
trition in every tissue of the body is improved. The 
figure is restored to its normal lines, the chest is 
deepened, a gain in weight is noticed. Free use 
of the lungs always means strength. The mouse 
breathes 150 times per minute, the elephant only 
six. The rule holds good in human beings : a high 
respiration means shallow breathing, shallow 
breathing always means a loss of strength. Deep- 
breathing increases our self-control, self-realization, 
self-expression. Yet normal and natural breathing 
among civilized people is rare. 



2l6 THE WORKING PEOPLE: THEIR HEALTH 

The present system of dress and tight-lacing 
among women prevents the free use of the lungs. 
In natural breathing the spine is straight, the body 
is held erect, and the entire trunk, chest, back and 
abdominal walls expand when we take in fresh air 
and contract when the air is expelled. Breathing 
is the most important act of our lives. Proper 
breathing means a change in one's whole being. It 
means an increase in bodily weight, it means a fresh 
tint to the cheeks, it means an elastic step, and above 
all it means a well-balanced nervous system, which 
is the keynote and which is necessary if we would 
be successful in any walk in life. 

We must not be nervous, but now you are going 
to ask me, "How shall I take these exercises of 
which you speak?" Now, if I gave you a list of 
complicated movements to learn, if I gave you 
movements which would take a great deal of time, 
you would not follow them, but those I am going 
to give you will be so simple that there will be no 
excuse for not putting them into action. 

EXERCISE NO. I 

Stand with the heels together, head erect, 
shoulders pushed back. Now close the lips, take 
a deep breath and count to yourself twenty, draw- 
ing in air all the time. While you are doing this, 
gently raise the arms until they are at a right 
angle with the body; now lower them slowly until 
you have emptied the lungs. Then, begin again, 
this time carrying both arms into the air, bringing 
them together, palms touching over the head. Now, 



AND HOW TO PROTECT IT. 217 

lower them slowly and at the same time empty the 
lungs. Repeat this four or five times before an 
open window, morning and night, and you will be 
surprised to find how much you have gained in 
lung expansion in a short time. This exercise 
brings into action nearly every muscle of the trunk. 
Repeat the same movement. This time don't bring 
the hands together, but turn them palms outward, 
throw the head back, and stretch as if you would 
touch the ceiling. 

EXERCISE NO. 2 

Without any apparent effort stand straight, place 
the hands upon the hips, allow the head to fall on 
the chest and then allow the chest to fall together, 
as it were. Now commence to take a long, deep 
breath, inhaling slowly and steadily, all this time 
with the lips tightly closed; count to yourself until 
you have counted forty, and then slowly exhale as 
before. 

EXERCISE NO. 3 

Place the back of the hands just under the 
shoulder blades, bend slightly forward while you 
draw in the breath, filling the lungs; then keeping 
the hands in the same position, raise the head, bend- 
ing it backward; at the same time empty the lungs 
slowly. 

You will notice that I have given but three very 
simple rules for deep breathing. Always remember 
in carrying out these exercises to take plenty of 
time, both in the act of inspiration (breathing in) 



2l8 THE WORKING PEOPLE: THEIR HEALTH 

and in exhaling (emptying the lungs). The every- 
day practice of these rules will result in a steady 
increase in the capacity, shape and flexibility of the 
chest, it will impart new qualities to singing and 
speaking, but the main and most important thing 
that it will do is, it will put into exercise, build 
up and make strong the apex or top of the lung, 
which by reason of its non-use is the most frequent 
seat of consumption. 



AND HOW TO PROTECT IT. 219 



CHAPTER XXXVII 
Worry and its Effect upon the Health 

"Laugh, and the world laughs with you; weep, 
and you weep alone," has the philosophy of the 
ages behind it. Men and women do not like to 
associate with those who are perpetually bemoaning 
their hard luck, and they turn with eager haste to 
the clown, the jester and the imp. Not until the 
last few years, however, have men come to realize 
that fear, anxiety, depression, all that is summed up 
in the little word worry, had a positively baneful 
effect on the physical system. Emerson urged, 
"Fear nothing but fear," and he never phrased four 
truer words. Ninety per cent, of all our ills and 
hardships are imaginary; the hardest obstacles we 
have to overcome in life are shadows, and the world 
of fact contains more ghosts than the world of 
fancy. 

Unfortunately, the more ambitious a man is the 
more likely he is to worry. The phlegmatic chap 
who wakes up some morning and finds himself at 
the top of the ladder, accepts his position philosoph- 
ically. Not so with the ambitious man who has 
struggled upward through the night. He knows 
what it has cost in blood and sweat and tears to 
gain his place, and he trembles lest he lose it. The 



220 THE WORKING PEOPLE: THEIR HEALTH 

great trouble with the chap who plots and plans 
and schemes to get on is the fact that he feels that 
everyone else is planning, plotting and scheming 
to get honor ahead of him. Nothing is gained by- 
undue fear or doubt as to the outcome. A cheerful 
faith, a serene confidence in yourself and trust in 
your fellow-man is absolutely essential to a healthy 
as well as a well-ordered life. 

When I was a senior at college, I more than once 
heard a man in my class express doubt as to his 
ability to matriculate. "How are we ever going to 
get through?" he would say. When confronted by 
that problem I always pointed with assurance to 
the men in the preceding classes. "In what respect," 
I would ask, "are they superior to us? They per- 
formed their work and received their diplomas, and 
so shall we." And so we did, doubting Thomases 
and all. 

It is so in life. My reader, the duties you are 
performing, the crosses you are bearing, the 
obstacles you are overcoming, have all been per- 
formed, borne and overcome by men and women 
for thousands of years before you essayed them. 
They all discharged them, and so can you. There 
is nothing in the tomorrow that can injure you if 
you are not willing to let it. To my sick friends, 
in particular, I want to impress upon you by all 
that you hold dear not to worry. If for any reason 
you are laid on a bed of illness, call a good physi- 
cian, give your case into his hands, tell him freely 
and fully all about yourself, take whatever medi- 
cines he prescribes faithfully, and trust him utterly. 
Worrying because you do not immediately recover 



AND HOW TO PROTECT IT. 221 

will undo all the good that your doctor can possibly 
do and will render void and of no effect the most 
potent remedies and the most powerful drugs. 

Don't worry ! It not only undermines the health, 
but it saps the will and so confuses and dazes and 
shocks the intellect, through dread of this, that and 
the other calamity, that it super-induces insanity. 
We have banished the witches and the ghosts and 
the "bogy man," but King Worry afflicts us more 
than the habitants of a thousand Endors. 

New York State does not know what to do with 
her insane patients, fully one-quarter of whom owe 
their unfortunate position directly to worry and to 
nothing else. Our forefathers built up healthy 
bodies and rugged constitutions by trust in God and 
faith in themselves. They believed there was room 
enough on this continent to set up a church with- 
out a bishop, and a state without a king, and 
although they were menaced by the Stuarts in 
England, and the Indians in America, they suc- 
ceeded in planting in this wilderness the mightiest 
democracy the world has ever known. Plain, 
simple and homely lives they lived, rough knocks 
they sustained, few comforts they knew, but their 
jails were few and far between and among them 
no insane hospital was known. Whatever else the 
Puritans did, they didn't worry. 

Not only the insane hospitals, but the operating 
rooms of all our hospitals are filled with worry vic- 
tims, brought there by excessive strain due to un- 
natural and uncalled-for labor in some field of effort. 
Do not furnish the material for the lance and 



222 THE WORKING PEOPLE : THEIR HEALTH 

scalpel by worrying. Take things easy. Do not 
bolt your food ; do not run for the cars ; do not 
neglect a cold; do not dissipate either in eating or 
drinking, but above all, as you value your health, 
your strength, your sanity itself, do not worry! 



AND HOW TO PROTECT IT. 223 



CHAPTER XXXVin 
Heart Disease, its Cause and Prevention 

The term heart disease is so broad that I shall 
not attempt to point out the various forms of dis- 
eases of the heart, but shall endeavor to make plain 
some of the most common causes of diseases of the 
heart and the method of preventing the same. 
There is no doubt that disease of this organ in one 
of its forms becomes more prevalent year by year, 
that in many cases it is never recognized until it 
is too late, when the treatment becomes simply 
symptomatic. By this I mean that after the disease 
actually exists, the only treatment is to treat the 
symptoms as they arise. The enormous mortality 
from disease of the heart is best shown by a study 
of vital statistics in 1907. The recorded death rate 
from heart disease in the United States was 59,157, 
so it is easy to see that this disease carries off a 
large army annually. Also diseases of the heart 
place an army of working people annually in a 
condition where they cease to become bread-win- 
ners, but become great sufferers and ofttimes a 
burden, not only upon the family, but upon the 
community. 

I remember well an instance of a patient in one 
of our city hospitals who was cared for for a 
period of more than eleven years. It is a disease 



224 THE WORKING PEOPLE: THEIR HEALTH 

that creeps on sometimes without the patient even 
knowing that he or she is afflicted with it, until it 
is too late to repair damages already done to not 
only the heart, but the general system. It is becom- 
ing more common year by year and will increase 
under the strain consequent to our American 
civilization. 



ITS CAUSES ARE NUMEROUS 

The most frequent cause of heart disease is the 
excessive and constant use of alcoholic stimulants, 
which weaken the heart muscle by a process of 
slow poisoning. The continued use of alcohol 
lowers the resisting powers of the body, bringing 
about an acid condition of the blood; this in turn 
produces rheumatism, which always predisposes to 
and causes a diseased condition of this organ. If 
you would avoid heart disease let alcoholic stimu- 
lants alone. 



RHEUMATISM AS A CAUSE OF A DISEASED HEART 

The excellent researches of Pitcairn in the seven- 
teenth century throw valuable light upon this sub- 
ject and connect it directly with rheumatism. 
Chambers gives it as occurring in 13 per cent, of all 
cases of rheumatism; Ormerod, in 71.7 per cent, 
of all cases. Poynton found it to exist in 75 per 
cent, of all rheumatic affections. So it is easily 
seen how necessary it is to avoid rheumatic affec- 
tions if we would avoid disease of the heart. 



AND HOW TO PROTECT IT. 225 

FATIGUE AND OVERWORK AS A CAUSE 

I have told you in another chapter that fatigue 
was a common cause of rheumatism ; if this is true, 
it must necessarily be one of the potent causes of 
disease of the heart. The heart depends largely 
upon a well-balanced nervous system for its 
strength and regularity of action, therefore, any 
undue strain upon our nervous system predisposes 
to this disease. Late hours, lack of proper rest and 
sleep, all tend to weaken this vital organ. Worry 
is another common cause, this because of its strain 
upon the nervous system. Lack of proper exercise 
is another cause of heart disease, also overeating. 
Therefore, if we would avoid this great American 
disease we must avoid excessives of all kinds and 
live the simple life to the letter. 



226 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XXXIX 
How to Cook for the Sick 

When overtaken by disease it is of the utmost 
importance to secure the services of a skilled phy- 
sician. It is also important to have a careful and 
painstaking nurse. Either of these can give you 
proper instructions as to what to cook and how to 
cook it; but, alas, only a small percentage of people 
can afford a nurse, and many can afford but a lim- 
ited number of calls from a physician, and in these 
few visits he cannot take time to teach you how to 
cook. Indeed, it is surprising to see how many 
physicians will say "avoid certain things and eat 
anything else you want." Now, this "something 
else" may be all right to eat providing it is cooked 
properly. But cooking for the sick and for those 
recovering from sickness differs as widely as any 
two things can, and while I shall not attempt in 
a book of this kind to give you a complete system 
of cooking, I shall lay down a few simple rules 
which I hope will prove helpful. I shall cover only 
those things which I consider most nourishing and 
best calculated to be borne by a stomach, both in 
acute illness and by those who are convalescing. 

First of all, I desire to say that in all acute ill- 
nesses, where fever is present, withhold all food for 
a period of twelve hours. In cases of nausea and 



AND HOW TO PROTECT IT. 227 

vomiting*, until the physician arrives, give no food 
of any kind and instead of water give small pieces 
of chipped ice. This can always be obtained either 
of your grocer or druggist. 

Below I have given a few recipes for the prepar- 
ing of foods most easily borne by a delicate stomach 
and which stand highest in the scale of nutrition. 

BEEF-JUICE 

Select a piece of raw, round beef. Have it cut 
about one inch in thickness, remove the fat, cut it 
into small pieces, place it in a jar with the top off. 
Cover with cold water. Set this jar in a kettle of 
water and allow the whole to come to a boil. Boil 
briskly for five minutes. Strain and season to suit 
the taste. 

CHICKEN BROTH 

Select a fowl and wash thoroughly, cut off dark 
meat in thin slashes, crack the bones and cover with 
two quarts of water. Bring to a boil and simmer 
for about four hours, or until the liquid is reduced 
about one-half. Add a little salt and when cold 
remove fat from the top. 

MUTTON BROTH 

Select the neck of a mutton, cutting it up into 
small pieces. Put into a kettle and cover with 
cold water, slowly letting it come to a boil. Now 
simmer for about four hours, strain, season with 
salt, and when cold remove the fat. 

BEEF JELLY WITH IRISH MOSS 

One-half of a cup of Irish moss, one and one-half 
cups beef broth well flavored. Soak the moss in 



228 THE WORKING PEOPLE: THEIR HEALTH 

warm water for fifteen minutes, wash each piece 
thoroughly with cold water, drain and cover it with 
broth, let it soak twenty minutes and then slowly 
heat, stirring all the time, and simmer for fifteen 
minutes. Strain through a piece of cheesecloth, 
stand in a cold place to harden. 

MILK OR RAISIN PORRIDGE 

Two dozen of large raisins, one-half tablespoon- 
ful of cornstarch, one pint of cold milk, two pieces 
of loaf sugar. Slit the raisins and remove the seeds, 
cover with milk. Cook one-half hour at a tempera- 
ture of 155 degrees. Moisten the arrowroot with 
a very little cold water, add the milk, cook until it 
is thick, strain and pour over the sugar. 

MILK PUNCH 

One and one-half cups of milk, one and one-half 
teaspoonfuls of sugar, a little nutmeg and one and 
one-half tablespoonfuls of brandy. Mix altogether 
thoroughly, and shake. 

toast 

Bread, perferably two days old. Cut into thin 
slices one-half inch thick. Dry thoroughly, either 
in an oven or broiler. Then increase the heat by 
means of direct flame, or by placing it in the oven 
until it becomes brown to the centre. 

TOASTED ROLLS 

Break the rolls into halves, then dry as directed 
under Toast, and then brown. 



AND HOW TO PROTECT IT. 229 



SOUPS 



If you desire to make broth or soup have your 
meat covered with cold water. Cook slowly to 
draw out all flavor and soluble matter. The meat 
or vegetable to be cut into small pieces. Soups are 
better if made the day before they are to be used, 
that the soup may get thoroughly cold, then all the 
fat can be easily removed before it is re-heated. 
In making soups always stir with a wooden spoon. 
Clear soups may have added nourishment by add- 
ing a little rice, barley, etc. They are, however, all 
stimulants and prepare the stomach for substantial 
dishes that follow. To be palatable they should be 
served hot. 

VEGETABLE SOUP 

One and one-half pints of stock, one ear fresh 
corn, one teaspoonful of rice, two tablespoonfuls 
of young peas, one tomato. Salt to taste. Cut the 
celery and carrots into small pieces, boil one and 
one-half hours. Score the corn, prepare the tomato 
for stewing, remove skin and seeds and add them 
to the soup. Boil ten minutes and season to taste. 

GRUELS 

All gruels must be free from lumps and thorough- 
ly cooked. Most of the preparations of grains 
should be cooked longer than is advised by the 
manufacturers. When some nutriment is desired 
eggs may be added, beating up the whites to a froth 
and stirring into the gruel before it is removed 
from the fire. Avoid too much sweetening. 



230 THE WORKING PEOPLE: THEIR HEALTH 
INDIAN MEAL GRUEL 

Three tablespoonfuls of corn meal, two table- 
spoonfuls of cream, one-half teaspoonful of sugar, 
one pint of boiling water, two-thirds of a teaspoon- 
ful of butter. Cover the meal with water, stir 
slowly, add the boiling water, keeping up a con- 
stant stirring. Add a little salt and cook in a 
double boiler for two hours. 

INDIAN MEAL GRUEL WITH EGG 

Make a quart of gruel as directed in the previous 
recipe, and before it is removed from the fire, add 
the beaten yolks of three eggs, then stir in the well- 
beaten whites. Cook for four minutes, stirring 
briskly. Serve as above directed. 

EGGS 

Eggs contain much nutrition, but to be digested 
easily must be served raw. The so-called soft 
boiled eggs must not be boiled at all. Boiling 
water is poured over the egg and then kept off the 
stove; in fifteen minutes the water will be cooled 
to about 150 degrees Fahrenheit. Eggs to be 
easily digested should never be fried. 

SPRING CHICKEN BROILED 

Singe it. Carefully remove the head and feet and 
split the chicken down the back; remove the intes- 
tines and wash the inside thoroughly. Place it on 
a broiler with the inside next to the fire, broil 
slowly for one-half to three-quarters of an hour. 
Just before it is done it should be turned and 



AND HOW TO PROTECT IT. 231 

browned on the other side; dust with salt, spread 
with butter. 

SCRAPED BEEF 

Select a pound of beef, preferably round. Have 
the meat cut into slices, place on a board and scrape 
it lightly with a sharp knife, first on one side and 
then on the other, until you have all the meat sep- 
arated from the fibres. This can then be placed 
in a pan and broiled. Season with a little salt and 
add a little butter, 

BROILED BEEFSTEAK 

(Have your steak cut one and one-half inches in 
thickness. Heat the wire broiler and rub the wires 
quickly with a piece of suet. Then hold the broiler 
near the fire and sear it quickly on one side, turn- 
ing it often. Steak an inch in thickness requires 
about twelve minutes or thereabouts to cook. 
When done, dust on a little salt. It is better served 
in a heated dish in which butter has been placed. 

BAKED FISH 

White fish is best used. Wash quickly in cold 
water. Place in a baking pan, dust on pepper, 
cover the bottom of the pan with boiling water, add 
one and one-half teaspoonfuls of salt, which had 
better be placed at the end of the pan. Bake in 
hot oven, basting every fifteen minutes, add boil- 
ingj water when it evaporates. Bake fifteen min- 
utes for each pound. 

EGG-NOG 

One egg y one and one-half teaspoonfuls soluble 
saccharine, water solution, one and one-half tea- 



232 



THE WORKING PEOPLE : THEIR HEALTH 



spoonfuls of glycerine, one and one-half pints of 
milk, two teaspoonfuls of brandy or whiskey. Beat 
the egg until light, add the milk and sweetening. 
This should always be added after the milk. Pour 
from one glass to another several times. 

MILK PUNCH 

One cup or more of milk, one and one-half table- 
spoonfuls of soluble saccharine, water solution, or 
one and one-half teaspoonfuls glycerine and one 
teaspoonful of soluble saccharine, water solution, 
three teaspoonfuls of whiskey. Mix all together, 
beating or shaking until frothy. Pour from one 
cup to another. 

CUSTARDS 

Two-thirds of a cup of milk, yolks of two eggs, 
two teaspoonfuls of soluble saccharine, water solu- 
tion. Beat the eggs until they are light, heating 
the milk, then pour slowly into the egg; cook by 
stirring continuously until a rich cream is formed, 
then pour from one vessel to another. Sweeten to 
taste. Add two teaspoonfuls of sherry. Nutmeg 
may be added. 

BAKED APPLES 

Baked apples can always be given to the sick. 
The proper way for baking: put one cup boiling 
water into a small pan, add one teaspoonful of 
glycerine and one teaspoonful of solid saccharine, 
water solution; then add the desired quantity of 
apples, which have been pared, cored and sliced. 
See that the dish is covered and bake until done. 



AND HOW TO PROTECT IT. 233 



CHAPTER XL 
Family Medicine Chest. 

Based upon an experience of fifteen years in the 
general practice of medicine, my opinion is that no 
family should be without a cabinet installed in the 
home containing many simple yet ofttimes potent 
remedies, which can be brought into play in emer- 
gency or while waiting for the family physician, and 
which, especially if living in the country, will oft- 
times save much suffering before medical aid can 
be obtained. This cabinet should contain the fol- 
lowing: 

One hot-water bag; one douche bag; one box of 
seidlitz powders ; four ounces spirits of turpentine ; 
one ounce aromatic spirits of ammonia; one ounce 
tincture of iodine; one pint of creolin; one-half 
dozen two-inch sterilized bandages; one box of 
mustard. 

One ounce of adrenal solution. Cotton soaked in 
this and packed tightly in the nose in case of severe 
bleeding or applied to a cut until the doctor arrives. 

Liquid collodion, applied on cotton to a cut to 
stop bleeding or to close open wound after it has 
been cleaned by a solution of creolin; 

One box stearate of zinc. Useful as an applica- 
tion for bed sores. Bathe the parts first with a 



234 THE WORKING PEOPLE: THEIR HEALTH 

solution of powdered alum, teaspoonful to a cup of 
water, then dry and apply the zinc. 

Severe Earache. — Atropine, grain one, water one 
ounce ; mark for the ear. Four drops dropped into 
the ear every fifteen minutes. 

The cabinet should also contain : four ounces of 
powdered borax; one ounce of powdered alum; one 
ounce liquid collodion ; one nasal douche ; one ounce 
P. D. & Company nasal tablets; one quart carron 
oil; one pair tweezers; one Esmarch rubber band- 
age ; one small bottle hydrogen peroxide, glass stop- 
per; two ounces sweet spirits of nitre. 

HOT-WATER BAG 

Many uses can be made of the hot-water bag, 
applying it to the abdomen in severe pain of colic; 
useful in case of chill and neuralgia, where moist 
heat is indicated. 

DOUCHE BAG 

For rectile douche or injection in case of consti- 
pation, and in severe pain in the bowels caused by 
gas. One quart of soap suds and water, to which 
one-half teaspoonful of turpentine has been added. 
If injected into the bowel, instant relief is afforded. 

SEIDLITZ POWDERS 

Useful in attack of acute stomach trouble caused 
by gas; also in biliousness; also in vomiting and 
constipation. 



AND HOW TO PROTECT IT. 235 

TURPENTINE 

Two teaspoonfuls added to a quart of hot water; 
wring* out a flannel from this solution and apply it 
across the bowel, for pains in the bowels. Two 
teaspoonfuls of turpentine, one-half cup of lard; 
spread between two pieces of cloth, apply to the 
chest in acute cold. 

SPIRITS OF AMMONIA 

Teaspoonful to one-half cup of hot water, for 
fainting. If fainting continues give one-half tea- 
spoonful to one-half cup of hot water, every fifteen 
minutes, for four or five doses. 

TINCTURE OF IODINE 

Paint over sore and inflamed joints or muscles. 
Paint the chest in case of hoarseness. Apply to 
swollen and inflamed glands of the neck. Used in 
acute and inflammatory rheumatism. 

CREOLIN 

Teaspoonful to a cup of water in case of cuts. 
Teaspoonful to the quart of water as a vaginal 
douche. Useful in felons, after they have been 
opened. 

ONE AKALOL DOUCHE 

Useful for catarrh of the nose and throat. 

CARRON OIL 

Always use in case of burns or scalds. Apply 
freely. 



236 THE WORKING PEOPLE: THEIR HEALTH 
SWEET SPIRITS OF NITRE 

Teaspoonful to a glass of water; give two tea- 
spoonfuls of this solution to a child every fifteen 
minutes for fever or suppression of urine. 

ESMARCH RUBBER BANDAGE 

In case of severe hemorrhage (bleeding) of the 
hand or foot or finger, apply tightly above the 
wound, to stop the flow of blood. 



AND HOW TO PROTECT IT. 237 



CHAPTER XLI. 
Protection of Health 

Through the kindness of Mr. Alexander M. Wil- 
son, Secretary of the Boston Association for the 
Prevention of Tuberculosis, I have obtained per- 
mission to reprint here that organization's excellent 
circular on Protection of Health. The information 
contained in this document was prepared by com- 
petent men with much care, and as I regard it as 
invaluable, I would recommend a careful perusal 
of the following pages: — 

DEEP BREATHING 

"Live with fresh air about you. Breathe through 
the nose. Wear loose, comfortable clothing that 
does not bind or pinch the body anywhere. Stand 
erect with chest high and head thrown back. 

CLEANLINESS 

"Keep your mind and body clean. Don't give the 
face or hands a monopoly of such attention. Take 
a sponge-bath and rub-down every day. Keep the 
teeth sound and clean by brushing them night and 
morning, and rinsing the mouth after eating. Go 
to a dentist regularly. 



238 THE WORKING PEOPLE: THEIR HEALTH 
EATING INCLUDES CHEWING 

"Eat well-prepared simple food at regular times. 
Chew the food thoroughly. Chewing is necessary 
for digestion. Do not wash your food down with 
water. Drink all the water between meals that 
you care to. 

REGULAR EXERCISE 

"Regular outdoor exercise preserves the health, 
but do not get overtired. 

"Exercise should be taken in moderation, and at 
least an hour should be spent out of doors in some 
work or occupation that is congenial. Those who 
have tuberculosis should take only such exercise 
as their doctors order. 

SLEEP 

"Sleep alone. Sleep at least eight hours each 
night. Have the windows always open. 

"Be as careful to avoid tuberculosis-infected air 
and houses as you are water and milk contaminated 
by typhoid germs. 

"Consumption causes one death in every four, 
occurring between the ages of twenty and forty. 
Thus it finds most of its victims at the active work- 
ing age, and carries off young men and women 
just entering upon the serious work of life, fathers 
and mothers of families, bread-winners and citizens 
at their most useful period. Consumption is more 
prevalent in certain climates and among certain 
races, but it spares no nation, no age, no occupation, 
no class of people. 



AND HOW TO PROTECT IT. 239 

CONSUMPTION IS A PREVENTABLE AND A CURABLE 
DISEASE 

"Consumption can be prevented. It can be cured 
if taken in time. It is not necessary to leave New 
England to be cured. All authorities now sub- 
scribe to the views advanced by Hippocrates, the 
father of medicine, who lived 460-377 B. C, viz., 
'If the patient (consumptive) is treated from the 
beginning he will get well/ 

NATURE OF THE DISEASE 

"The cause of tuberculosis is a living germ — a 
tiny plant which can be seen only through the 
microscope. 

"This germ, called bacillus tuberculosis, usually 
gets into the body by way of the mouth, when we 
are improperly using it, instead of the nose, to 
breathe through, or when we put something into 
our mouths which is contaminated through previous 
use by a consumptive. 

"Tuberculosis germs most frequently lodge in 
the air-passages of the lungs. They may also get 
into the glands of the neck, attack the throat, the 
bowels, kidneys, brain or other organs, or the bones 
or joints. It is always the same germ working in 
the same way to destroy different tissues. If the 
workings of the germs are not stopped, the capac- 
ity of the lungs and other organs to do their work 
is gradually reduced, until death results. 

"If it were not for the power that vigorous 
people, living healthy lives, possess to resist dis- 
ease in general, it is probable that consumption 



240 THE WORKING PEOPLE: THEIR HEALTH 

would kill off whole communities. It is hardly pos- 
sible that any single inhabitant of a city, where 
many have consumption, could entirely escape 
breathing into his lungs some living germs of the 
disease. Fortunately in the fresh air and sunshine 
these germs live only a short time, while in an 
ordinary room kept dark and close, they may live 
months or even years. 

"In the organs of the body, when the germs are 
not killed immediately, they produce little lumps 
called tubercles. In the lungs these grow, soften, 
break open and are expelled by coughing or other- 
wise. An ulcer or cavity containing many of the 
disease germs is left behind. In cure, nature builds 
a wall of scar tissues about the tubercle or cavhry. 
This wall becomes gradually thicker and thicker, 
growing* towards the centre until nothing is left 
but a scar. This means perfect cure. 

"Until the scar tissue has thoroughly choked out 
the bacilli, it may break down at any time, leaving 
the bacilli free to continue their action at that place ; 
then a relapse ensues. 

NOT INHERITED 

"Many will be comforted to know that the dis- 
ease is not inherited, as it was long thought to be. 
The children of parents who are consumptive or 
otherwise run down and weakened, frequently in- 
herit narrow chests, a low vitality, or generally 
poor physique. If they are not especially cared for 
and protected against infection, they are very 
likely to get the disease. Such children, and per- 
sons who are regaining health and strength after 



AND HOW TO PROTECT IT. 241 

illness, or who are engaged in dusty work, should 
guard and build up their health, systematically and 
persistently. Ex-president Roosevelt is a promi- 
nent example of one who, by following such rules as 
those on pp. 237-8, developed a poor physique into 
an exceptionally fine one. 

"The cases of so-called 'hereditary consumption* 
are due to the disease being transmitted from one 
afflicted member of the family to another, either 
directly through personal contact, or through the 
medium of dirt and dust in the infected rooms. 

THE VALUE OF FRESH AIR 

"The value of fresh air cannot be over-estimated. 
Fresh air contains much oxygen, bad air very lit- 
tle. Blood is made red and pure by breathing in 
the oxygen of fresh air. New body tissue is built 
out of such blood. It makes the muscles active and 
the brain quick. Therefore do not work or sleep 
where there is no fresh air. Do not stay in a 
theatre, church, or other meeting place where your 
lungs are starved and poisoned for want of it. 
Breathe through your nose. That is what it is for. 
It smells bad air and so warns you. It filters out 
the dust and germs from the air breathed through 
it. The mouth has no filter for air, so those who 
breathe through it load their lungs with dirt and 
are more apt to get sick. 

THE DANGER OF CARELESS SPITTING 

" 'No one in health spits/— Dr. Flick. 
"Except when one gets something nasty, like an 
insect or tobacco in the mouth, this is true. Many 

16 



242 THE WORKING PEOPLE: THEIR HEALTH 

get into the habit of spitting and so of wasting the 
saliva, which is meant to keep the mouth clean and 
to aid in digestion. Do not spit unnecessarily. 
When it is necessary, spit into the water-closet, a 
spittoon, a spit-flask, a cloth or paper that can be 
burned. Less safe than these, but far better than 
the floor or sidewalks, is the gutter. Remember 
that while your spit may be only nasty and not 
dangerous, some one else who has a contagious dis- 
ease that is commonly spread in this way, such as 
tuberculosis or diphtheria, is likely to follow your 
example. The poisonous spit is tracked and car- 
ried by flies, or dries and is blown or brushed about 
as dust. 

"If women should spit as commonly as men do, 
how noticeable and disgusting it would be! 

"The consumptive in himself is almost harmless. 
He becomes harmful usually through bad habits, 
which are due, as a rule, to ignorance. The con- 
sumptive at home or who walks about, works in 
offices or shops, will not transmit his disease to 
those with whom he comes in contact if he takes 
proper care of his spit. 

CONDITIONS FAVORING THE SPREAD OF TUBERCULOSIS 

"It has been found that the vast majority of 
those infected are persons who have lived un- 
hygienic lives, or who are compelled, in order to 
gain a livelihood, to work amidst unhealthful sur- 
roundings or too long hours. Healthy persons, liv- 
ing a proper life, when infected, frequently get over 
the disease so easily that they do not even know 
that they had it. 



AND HOW TO PROTECT IT. 243 

"Overcrowded, poorly ventilated houses, offices 
and workshops, inactive occupations with lack of 
regular exercise in the fresh air, trades causing 
much dust, which, irritating the lungs, produces a 
condition favorable to the growth of the germ. 
Continued exhaustion from overwork, poor food 
and insufficient clothing, uncleanness, and espe- 
cially intemperance, are all factors in predisposing 
persons to consumption; but it must be remem- 
bered that nothing can actually cause consumption 
except the entrance of the germ into the body. 
Consumption is common in persons living indoors 
and where there is not enough fresh air. It is rare 
among those living out of doors and sleeping in 
rooms well supplied with fresh air. It is most com- 
mon in the crowded parts of cities. It is least common 
in the suburbs where people live in separate houses. 

"No matter where the germs are, on floors, side- 
walks, cars, on clothing or dishes, they are helped 
to live by dirt, dampness and darkness. On the 
other hand, sunshine, pure air and cleanliness are 
most valuable means of resisting and destroying 
the infection and preventing the disease. Keep 
your premises clean. Have a thorough spring and 
fall house-cleaning every year. 

"Houses and rooms occupied by consumptives 
often become so infected with its germs that 
healthy persons afterwards occupying them often 
get consumption. Such rooms should, therefore, 
be disinfected and renovated before being used 
again. 

"In four of the wards of Boston there are over 
twenty houses which have had five or more cases 



244 THE WORKING PEOPLE: THEIR HEALTH 

of tuberculosis in succession during the last eight 
years. Such houses may fairly be said to be seats 
of infection and will probably continue to give con- 
sumption to their tenants until thoroughly made 
over. 

"The only sure way of preventing the infection of 
premises or other persons directly is carefully to put 
all the germ-filled spit out of harm s way by either 
burning it or throwing it down the water-closet. 

"Do not dread being near a careful, clean con- 
sumptive. Do not regard this disease as contagious 
to the same extent as smallpox, diphtheria or scar- 
let fever. Much harm has been done through un- 
fair fear of the consumptive, which has caused him 
to be avoided as a leper. Consumptives are only 
a source of danger through discharges from dis- 
eased tissues — chiefly the sputum, usually called 
spit — and if these are destroyed, ordinary life with 
consumptive patients is practically free from 
danger. 

"It has been proved that there is no infection in 
the ordinary breath of a consumptive. But the 
mouth should always be covered with a handker- 
chief or paper to catch the dangerous spray when 
coughing or sneezing). 

KEEP WELL 

"If your clothing or shoes become wet, make a 
change as soon as possible. Don't neglect a cold 
or a cough. Save yourself time, money and danger 
by calling on a doctor at once if you are sick. 
Countless graves are filled with those who had 
'just a little cold which will wear off.' Colds 



AND HOW TO PROTECT IT. 245 

reduce the vital forces and make it easy for the 
germs of pneumonia and consumption to get a foot- 
hold. An examination for your cough may save 
your life and that of others. Avoid patent medi- 
cines or 'cure-alls/ They are dangerous and 
useless. 

CONSUMPTION IS CURABLE 

"Consumption is curable when wise treatment 
is begun early. 

"The first symptoms of the disease may be loss 
of appetite and steady loss of weight, fatigue on 
slight exertion, general feeling of languor, lack of 
energy and ambition, rapid pulse, fever in the after- 
noon and evening, and a cough which is most no- 
ticeable in the morning. The cough may have 
existed for months with no evident injury to the 
general health; a slight, hacking cough, usually 
worse in the morning, may have occasioned so little 
annoyance that the patient will deny having a 
cough at all or will remember it only after careful 
questioning. Consumption often follows pneu- 
monia, 'grip,' measles and whooping cough. 

"As the disease progresses the symptoms become 
more distinctive. The evident wasting, the daily 
fever, the flushed cheeks, the night sweats and the 
continued cough and spitting, and determination 
that there are bacilli in the sputum, indicate defi- 
nitely the presence of the disease. 

"Bleeding from the lungs is a common symptom 
of consumption and often the first one noticed. 

"Any or all of these symptoms should cause the 
patient to seek at once the most competent medical 



246 THE WORKING PEOPLE : THEIR HEALTH 

advice. The State Board of Health and many local 
boards of health make examinations of sputum 
without charge. If you have the disease you will 
probably be advised to go to a sanatorium. Mas- 
sachusetts has established a State sanatorium at 
Rutland, Mass., where the charge to the patient is 
only $4 per week. About $5 worth of equipment 
is required. Each of the New England states has 
now made similar provision. There are also a num- 
ber of private sanatoria at which the charges are 
from $5 a week up. 

"The best treatment is outdoor life, rest, and plenty 
of good food under careful and constant medical 
supervision. This can be much better carried out 
at a sanatorium than at home, while going away 
"into the country to board" without competent and 
detailed medical supervision is not advisable. 
However, many persons who cannot for various 
reasons leave their homes and go to a sanatorium 
can get well, or at least improve their own condi- 
tion so far as to be comfortable and do a moderate 
amount of work, by putting themselves under the 
care of a physician and strictly following his advice 
and directions. 



HOME TREATMENT 

"Lack of accommodations in sanatoria and other 
reasons make it necessary for many cases to be 
treated in the home. We therefore give here some 
simple and general instructions. These instruc- 
tions will be changed by your physician as he 
thinks necessary to suit your case. 



AND HOW TO PROTECT IT. 247 

"1. The patient should have a covered porch or 
balcony, or a sunny, well-ventilated and comfort- 
able room, preferably on an upper floor. There he 
should sleep alone, with the windows wide open. 

"2. Dr. Knopf says : 'All extra furniture, dust- 
catching curtains, and carpets should be removed, 
but the room must not be made cheerless. A few 
rugs, washable curtains, some cheerful pictures, 
may well be allowed. If arrangements for outdoor 
sleeping at night and the rest-cure in the open air 
by day on piazza or roof be added, so much the 
better. To make the open-air treatment feasible 
by day and night, even in the homes of the poor 
living in cities, I have made what I call a "window 
tent." It consists of an awning on the inside of the 
room. It is so constructed that the air from the 
room cannot enter or mix with the air in the tent. 
The patient, lying in the bed, which is placed par- 
allel with the window, has his head and shoulders 
resting in the tent. By following the description 
closely it will be seen that the ventilation is as 
nearly perfect as can be produced with a simple 
device. The tent is attached to the frame of the 
window, but it does not quite fill the lower half. 
A space of about three inches is left for the escape 
of the warm air in the room. By lowering the 
window, this space can be reduced to one inch or 
less. The tent is constructed of four frames, made 
of steel or wood rods suitably formed and furnished 
with hinged ends ; the hinges operate on a stout 
hinge-pin at each end, with washers to insure easy 
folding. 



248 THE WORKING PEOPLE: THEIR HEALTH 

" 'The frame is covered with extra thick yacht- 
sail twill, properly fitted, and having long ends to 
tuck in under and around the bedding to prevent 
the cold air from entering the room. The patient 
gets in bed and then the tent is lowered over him, 
or by a cord and a little pulley attached to the 
upper portion of the window he can lower and 
raise the tent himself. Shutters can be used with 
the window-tent as a screen from the neighbors, 
and in stormy weather as a protection. The win- 
dow tent will not attract attention from the outside. 
A piece of transparent celluloid is placed in the 
front of the tent as a window for the nurse or mem- 
bers of the family to watch the patient and to make 
the patient feel less outdoors and more with his 
family, as he can see what is going on in the room. 

" Tn winter the patient's bed must be covered 
with enough blankets for his comfort and warmth 
throughout the night. The coverings should not 
be so heavy as to press down upon the body and 
make the patient feel uncomfortable or tire him. 
A tightly-woven real wool blanket is better than 
many loosely woven or shoddy ones, or comforters. 
To the poor it may be good advice to put several 
layers of newspapers between the coverings. This 
will make a cheap, light and warm covering. In 
extremely cold weather the patient, while sleeping 
in the window-tent, should wear a sweater and 
protect his head and ears with a woolen cap or a 
shawl. 

" 'Some patients complain that the light awakens 
them too early in the morning, and that they have 
difficulty in going to sleep again. I advise them to 



AND HOW TO PROTECT IT. 249 

have some light-weight but dark-colored material 
(such as a black lisle-thread stocking) to put over 
their eyes. 

" This fresh-air treatment must be begun grad- 
ually according to the patient. It should, however, 
be impressed upon him that night air is as pure as 
day air. It is best to begin by placing him in the 
tent for a few hours at night, and a few hours dur- 
ing the day in a chair. The doctor will regulate 
all this so as to get the patient gradually used to 
living in the pure cold air, day and night. A hot- 
water bottle for the feet may be necessary in very 
cold weather. The patient's feet must be kept 
warm if he is to benefit by the open-air treatment/ 
There are other good window-tents besides that of 
Dr. Knopf. 

"3. Whitewashed or painted walls are better 
than papered walls, because they can be often and 
cheaply whitewashed, or washed, and so kept clean 
and free of germs. 

"4. Expose the room freely and constantly, day 
and night, to the outside air, and sleep with the 
windows wide open unless you have a tent. Spend 
as much time as possible in the open air, and use 
the bedroom only at night. Do not get tired. Sit 
or lie most of the time in the open air. Except in 
the heat of summer sit in the sunshine as much as 
possible. Take only such kind and amount of exer- 
cise as the doctor orders from time to time. If 
there is much fever, stay in bed. As the fever dis- 
appears, and as the patient gains in strength, exer- 
cise may be gradually taken, but weariness must 
be guarded against. 



250 THE WORKING PEOPLE: THEIR HEALTH 

"5. Be properly clad, and keep the feet dry. Do 
not load the body down with too many clothes. Do 
not be afraid of cold weather as long as the body 
is warm. A consumptive is no more likely to catch 
cold than any one else. 

"6. Take a sponge bath each morning, and then 
rub the skin well with a coarse towel. We breathe 
through the skin as well as the lungs, and so the 
pores in the skin of the whole body must be kept 
open and clean. 

"7. There is no known medicine that can cure 
consumption. Medicines for the relief of cough and 
other symptoms of the disease should be taken only 
on the advice of a physician. 

"8. Lead a temperate life in all things. 

"9. Be scrupulously careful not to infect the 
other members of your family, or further to infect 
yourself, by distributing about the house or else- 
where the germs contained in your sputum. Have 
your dishes washed with boiling water. Have sep- 
arate soap and towels for your own use. Be sure 
to wash your hands before eating. 

"10. It is best not to use handkerchiefs to re- 
ceive the sputum. Japanese paper napkins or other 
soft paper, or pieces of old linen, may be used and 
should be burned. When you are walking about, 
these soiled pieces of paper, etc., may be collected 
in a paper bag and later burned, or one can use a 
destructible spit-cup, which can be bought for a 
few cents ; use one or more a day and destroy them 
by burning. 

"11. Never swallow what you cough up; it may 
cause an infection of your bowels. 



AND HOW TO PROTECT IT. 25 1 

"12. Scrupulously avoid dust, disorder, damp- 
ness, darkness and bad air in your home and else- 
where. 

"13. Be hopeful and expect a cure. 

"The consumptive is of little danger to any one, 
even in the home or workshop, if he is careful to 
obey these rules and directions. 



WHEN AND WHAT TO EAT 

"The following are good general rules to follow 
in relation to eating: 

"Food should be taken at least six times in the 
twenty-four hours; lunches between meals and on 
retiring. 

"Never eat when suffering from bodily or mental 
fatigue or nervous excitement. 

"Take a nap, or lie down, for at least twenty min- 
utes before the midday and evening meals. 

"Take plenty of food. Have it well and thor- 
oughly cooked. 

"The everyday simple foods are better than the 
dainties sent in to tempt the appetite by kindly 
friends and neighbors. 

"Chew the food thoroughly before swallowing it. 

"That one may regain lost weight it is usually 
necessary to add milk, which is a cheap and very 
desirable form of food, and also eggs to the amount 
of food ordinarily eaten. 

"The milk should be fresh and pure. 

"The experience of many thousands of persons 
has proved that there is practically no one who 
cannot take from one to two quarts of milk a day. 



252 THE WORKING PEOPLE: THEIR HEALTH 

"A consumptive should not be allowed to sit at 
a table with others, unless his hands and face have 
been carefully washed, and unless he is able to con- 
trol his cough while at the table. 

"Pleasant surroundings, a cheerful dining-room, 
an inviting table with a clean cloth and napkins, 
well-cooked appetizing food attractively served, 
help in the treatment of consumption. 

"To disinfect is to kill disease germs. 

"Disease germs are likely to be found wherever 
the sick person has been, and on all the things he 
has touched or used. 

"If the germs are not killed, they may make some 
one else sick and perhaps die of the same disease. 
The best way to kill them is to have plenty of sun- 
light and fresh air in the house, and especially in 
the sick person's room, and keep it clean and in 
order. In dusting use a damp cloth. For. the floors 
use a scrubbing brush, damp paper or sawdust, or 
a mop. Never raise a dust. 

"When the sick person moves away or dies, ask 
the board of health to disinfect. If the board of 
health will not act, you should get one and one- 
half pints of formaldehyde solution and eleven 
ounces of permanganate of potassium from the 
druggist. Open the closets and all the drawers and 
the bed, and spread around the room all the clothes 
and other things left by the patient. Close the win- 
dow, fireplace or other openings, pasting strips of 
newspaper over all cracks and keyholes. Put the 
powder in a hot dish-pan or metal pail in the mid- 
dle of the room. When everything is ready pour 
the formaldehyde solution into the pan and leave 



AND HOW TO PROTECT IT. 253 

the room at once. Keep the door closed for at least 
two hours. The larger the room the longer you 
should keep it closed. Open the windows from the 
outside, if possible, but if necessary to enter the 
room to open the window for airing after disinfec- 
tion, hold the breath, rush in and out again. This 
disinfection is cheap and effective and will not 
harm the things. Sulphur candles are nearly use- 
less. Formaline candles are expensive, and prob- 
ably less effective than the method described. 

"The disease germs are dead after this disinfec- 
tion. The whole place must then be cleaned and 
renovated. Burn papers, magazines, old clothes, 
rags and other useless things. Boil for fifteen min- 
utes all the dishes, pans, tableware, and brushes and 
combs. Linen, washable clothes, curtains, rugs, 
blankets, etc., should be boiled. Painted walls, the 
floor and the furniture should be scrubbed. White- 
washed or papered walls should be scraped and 
done over. The carpet should be burned or 
scrubbed and dried thoroughly in the sun. 

"When the person knows he has tuberculosis or 
any other contagious disease, he should begin to be 
careful not to spread the infection. During the 
sickness the spit or what is coughed up should be 
collected in paper napkins or in a cup with water 
and burned or thrown down the water-closet. All 
the patient's dishes and tableware should be boiled 
after every meal. 

"Dainties or other food left over by the patient 
must never be given to others or even to the cow, 
pig, chickens, dog or cat. 



254 



THE WORKING PEOPLE: THEIR HEALTH 



"It is dangerous and wicked to give away any- 
thing which has been exposed to disease until it 
has been thoroughly disinfected. 

"Report to the board of health any case of infec- 
tious or contagious disease in your family or house, 
as soon as you find out about it, unless the doctor 
says he has done so. You may be fined if you do 
not report it." 



AND HOW TO PROTECT IT. 255 



CHAPTER XLII 

Typhoid Fever — its Early Symptoms, and how 
it Can be Avoided 

Typhoid fever is a disease of youth and early 
adult life. It is caused by a specific germ and the 
greatest number of cases occur between fifteen and 
twenty-five years. Cases are rare in those over 
sixty years, but it is not infrequent in childhood. 
As in other diseases, not all exposed take the disease. 
We are glad to see that as sanitation is improved 
in our cities and villages, this disease becomes less 
frequent. It prevails most in hot and dry seasons ; 
it is caused by a specific germ which may be trans- 
mitted from one person to another, but it is taken 
in most often by the water we drink. Milk is also 
a source of infection. Oysters are a source of in- 
fection, in fact, in my opinion the eating of raw 
oysters causes more cases of typhoid than we for- 
merly supposed. Flies are a sure source of infection. 
If a case is carelessly handled in the neighborhood 
and soiled linen is left where they can light upon 
it, that same fly flying across the street into your 
unscreened window, can surely carry contagion to 
you. 

After this germ is taken into the system a num- 
ber of days may elapse before the patient begins to 
realize that he has contracted the disease. 



256 THE WORKING PEOPLE : THEIR HEALTH 

The early symptoms of typhoid can be mistaken 
for many other diseases — dull headaches, a feeling 
of lassitude, and sometimes a slight bronchitis, with 
a coated tongue. Usually either constipation or 
diarrhoea is present, The patient feels exhausted, 
"tired all the time," as he expresses it. These are 
the main early symptoms. If you are not sure 
about the water or milk you have been drinking, if 
you have been exposed by sleeping with a person 
having these symptoms, then it is well to consult 
a physician, who will immediately take a drop of 
blood from your ear and have it examined. The 
disease discovered early can be carried along under 
treatment so that you will have it light. If you 
live in the country, and typhoid breaks out, imme- 
diately give the following advice to the family: 
Look carefully to the privy, use plenty of chloride 
of lime, use it in the bed-pan when a stool is passed 
and dig a hole in the ground, put in a quantity of 
lime, deposit the stools, use more lime, and cover 
with earth. 

As I write this, I am watching an outbreak of 
typhoid in an adjoining town and the history of 
this might serve to show you how this disease will 
travel. Here we had a population of less than forty 
persons, and at the time I write, eleven are infected 
with typhoid, conveyed by the common house-fly. 
You may ask how I know this. An analysis of the 
water and milk shows them both to be free of the 
germ, yet a young man in this neighborhood, some 
three weeks ago, came down with the disease. He 
used a privy, the flies swarmed to the privy, and 
without question infected many other persons in 



AND HOW TO PROTECT IT. 257 

the neighborhood. The reason for this supposi- 
tion is this: That all the other persons who fell 
sick lived within 200 yards of this privy vault; 
therefore, you can see the absolute need of exercis- 
ing the utmost care in the care of the stools. 

I have now given you its most prominent early 
symptoms. I have said something about preven- 
tion, but in conclusion I want to say that here again, 
as in all acute and infectious diseases, the most im- 
portant step is to look carefully to< your general 
health during the typhoid season; if your stomach 
troubles you, treat it. If you are troubled with con- 
stipation, treat that, which can easily be done by 
simple laxatives. The care of the mouth and teeth 
is also an important factor in warding off typhoid, 
and the building up of the blood by a little iron 
helps to ward off this disease. Very few persons 
who are perfectly healthy contract it, although 
brought in direct contact with same. Remember 
that in this disease as in all others, cleanliness, both 
around your dwelling and about the body, with the 
shutting out of the common house-fly, are some of 
the very best preventive measures. 



17 



258 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XLIII 

For the Young Man, Shall it be the Factor? 
or the Farm? 

The desertion of the farm for the city and fac- 
tory life is a common cause of tuberculosis. This 
drain upon the rural districts must cease, other- 
wise we must produce eventually a nation of weak- 
lings. The death rate among those who follow 
agricultural pursuits is the lowest of any class and 
highest among those who leave the outdoor air for 
the stifling atmosphere of the factory and store. 
The offspring of the farmer has been the maker of 
history in the past, and to him we must look for 
stable stock in the generation to come. 

Did you ever stop to think of the number of 
times you have heard the expression, "You should 
spend a few weeks in the country if you would 
regain your health." Our large towns are fast be- 
coming overcrowded with young men who have 
left the farm to seek their fortunes in the city. A 
few find it, but 80 per cent, reach the city, learn 
a trade, get married, settle down, as they term it, 
and naturally enough raise children; then the 
trouble begins. As long as your health holds out 
and you can work, you are all right ; but if you fall 
sick and this sickness causes you to lose many 
weeks' pay, what happens? Bills at once accumu- 



AND HOW TO PROTECT IT. 259 

late, and when you are again back upon your feet 
it is with a weakened body and added responsibil- 
ities; for the back rent, the grocery bills and all 
the other bills must be paid or you are soon on the 
black-list; and all the time you must provide for 
the little ones God has given you, as well. 

We are told on good authority that in the city 
of Boston alone, there are ten thousand tubercular 
school children. We don't see many in the coun- 
try, do we ? No ! The opportunity for the boy 
today is greater in the country than in the city. 
Ponder well, young man, over the question, before 
you make a move, for the beginning of a young 
life foretells many times its end. When once you 
are harnessed down to the routine of city life and 
work by the week, you can't help thinking of the 
freedom of country life, its independence, its purity, 
its influence upon your character, its freedom from 
temptation and intrigues, into which so many fall. 
Honesty and uprightness, born in your country 
home, are often displaced through force of circum- 
stances in the city by dishonesty and the wedding 
yourself to bad habits from which it is hard to 
escape. 



26o THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XLIV 
Measles a Dangerous Disease, and Why? 

This is a child's disease and is supposed by the 
laity to be of little or no consequence, in fact, our 
grandmothers would tell us that we had better let 
the baby catch it and have it over with. In this 
particular I would agree with her, providing she 
will confine it to the baby at the breast and exer- 
cise the utmost care in its convalescence, but I 
want to say to you in the start that you are dealing 
with a dangerous disease if care is not exercised. 
In the first place, great care should be taken when 
it comes to the question of taking cold after an 
attack, and always remember that measles produces 
a sensitive condition of the bronchial tubes and 
makes the child particularly sensitive to bronchitis 
and broncho-pneumonia. 

Many a child has gone through life with weak 
eyes because care was not exercised in excluding 
the light during and after an attack of measles. 
The mucous membranes of the nose, throat, eyes 
and bronchial tubes are made very sensitive in 
all cases, so even with the baby it is always safe 
to have the family physician see the child once or 
twice, even if you have a mild case, and to follow 
his advice closely. The great mistake that is made 
in many cases where baby is lost is because the case, 



AND HOW TO PROTECT IT. 261 

being simply measles, is too often allowed to go un- 
treated. If the child is, say, two or three years old 
or older, or if an adult is attacked, then you should 
remember that you are dealing with a disease 
which is often followed by the dreaded enemy — 
broncho-pneumonia, and a weakened condition of 
the eyes, which, if not prevented, may follow the 
person through life. Home remedies may be pre- 
scribed by the family doctor and followed, but phy- 
sicians have come to realize that this disease is not 
a simple but a dangerous one. Cases are on record 
where the lives of both father and mother are 
lost, the disease having been contracted from a 
child. As I said in the beginning, prevent the child 
from having it if possible, as you would prevent it 
from having any other disease, because the fewer 
diseases a child has, the better. 



262 THE WORKING PEOPLE : THEIR HEALTH 



CHAPTER XLV 
The Young Man, the Cigarette and the Saloon 

Young man, as you are beginning life, let me 
say to you that a place at the top rung of the lad- 
der was never more to be desired than at the pres- 
ent time, and in starting out in life always have 
your eye on that spot. There are plenty at the 
bottom of the ladder, many who are content to re- 
main there, and many who would like to rise but 
cannot, because they are chained to- that spot by 
some vicious habit. It is not my purpose to give 
you a lecture on temperance, neither is it my desire 
to frighten you by telling you that the so-called 
ciglarette habit can have in store for you. only a 
blighted future and a sincere regret in after years. 

Choosing either or both of these as companions, 
what have you done? You have handicapped your- 
self at the very outset of your career. Have you 
ever seen a young man who has ever increased his 
physical strength, which is his capital, or his stand- 
ing in the community by the use of either of these 
things? If you can find one, follow his example; 
but you cannot! You, on the other hand, can put 
your finger on many a weak heart and many a weak 
body, made so by the saloon and the cigarette. 

For years as an examiner for different insurance 
companies, I have been saddened at the number of 






AND HOW TO PROTECT IT. 263 

rejections I have been obliged to make among 
people who could trace a weakened heart or a weak- 
ened lung to no other cause than alcohol and cig- 
arettes. As a physician I well knew that usually a 
blighted future and a stunted intellect and physi- 
cal growth must necessarily be the outcome of a 
continuance of these habits. 

Today men buy the most efficient machines when 
they desire the most efficient service. So our civil- 
ization receives its impetus and has its momentum 
maintained by the most efficient minds and bodies. 



264 THE WORKING PEOPLE : THEIR HEALTH 



CHAPTER XLVI 

Municipal Sanitariums and How they Can be 
Established 

At the last meeting of the National Association 
for the Study and Prevention of Tuberculosis, 
Holmer Falks, vice-president of this association, 
stated that it was his belief that there were at 
least seventy-five thousand advanced cases of con- 
sumption in the United States, with not over five 
thousand beds for their accommodation. Now, tu- 
berculosis is a communicable disease, that is, it can 
be contracted from one who is ill with it. If we 
ever stamp out tuberculosis, it will be when we have 
provided a place where suitable care can be given 
these cases and when they can be placed in institu- 
tions where their sputum cannot affect other mem- 
bers of their household. 

This leads directly up to the question of the 
establishment of municipal sanitariums, a bill for 
which I have prepared, and which will be presented 
to the next General Court of Massachusetts. This 
bill provides for a referendum to the people, and 
in substance means the elevation of the tax rate of 
city and town, one mill upon each dollar of taxable 
property, the money thus raised to be used in build- 
ing and maintaining sanitariums for all cases of 
consumption. I trust this bill will receive the sup- 



AND HOW TO PROTECT IT. 265 

port of every member of the House and Senate, for 
when it becomes a law it will not only reduce the 
death rate in Massachusetts, but it will save many 
a young life from the ravages of this disease. 

A few years ago in my private practice the father 
of a family of three contracted consumption. Not- 
withstanding the fact that he was early taught the 
danger of spitting and that he might infect other 
members of his family, he was careless, and as a 
result of his carelessness the older daughter con- 
tracted the disease and died. The mother con- 
tracted it from the daughter and died. The young- 
est child contracted it from the mother; she, too, 
fell a victim at the age of fourteen and passed away. 
Such chapters as these ought not be repeated, but 
until we establish municipal sanitariums for these 
cases, we must go on spreading the infection from 
one member of the household to another, for in the 
sputum lurks the danger. People never seem to 
realize the dangers from a consumptive where he 
must be cared for among other members of the 
family, and this is especially true where the fam- 
ily is large. 



18 



266 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XLVII 

Emergencies, and What to Do When they 
Arise 

The application of simple principles has saved 
thousands of lives. I remember well an instance of 
a hurried call which came to me. A small boy ran 

to my office, asking that I come at once to 

Street, to Mrs. Black, who was very ill. Upon 
arrival I found that a young girl of seventeen had 
drunk household ammonia. She had had a quarrel 
with a young fellow who was keeping company 
with her, and as a result she seized a bottle of 
strong ammonia and drank freely of same. Now, 
in this case, one must act quickly and make use 
of the most common remedies at hand. A large 
dose of vinegar, followed by a large dose of olive 
oil, administered at once, saved her life. Here are 
some easily get-at-able remedies for the ordinary 
emergencies of life: 



SCALDS AND BURNS 

These are most common in childhood. Always 
keep one quart of carron oil on hand; it will keep 
for years. Apply freely, cover with cheesecloth or 
clean linen, and send at once for your physician. 



AND HOW TO PROTECT IT. 267 



TINCTURE OF IODINE 



This is usually kept in the house and accident- 
ally may be drunk by a small child. At once give 
child flour mixed with water and white of eggs, 
while waiting for physician. 



NITRATE OF SILVER 

Give freely common salt, white of eggs and milk. 
Send at once for physician. 

SWALLOWING PIN BY BABY 

Don't get excited, unless it seems to stick in 
throat; if so, send to nearest physician 

SWALLOWING PENNY 

Large dose of castor oil. 

SWALLOWING BUTTON 

Large dose of castor oil. 

CLEAN CUTS 

Immerse at once in cold water, to which creolin 
has been added in the proportion of teaspoonful to 
cup. 

RAGGED CUTS 

Creolin and cold water, cloths wrung out in same 
and laid on the wound. Consult your physician. 

WOUNDS TO EYES 

Compresses of cold water. Consult your physi- 
cian at once. 



268 THE WORKING PEOPLE: THEIR HEALTH 



DRINKING OF CARBOLIC ACID 

Give freely milk, white of eggs. Powdered chalk 
should be given if at hand. Epsom salts. All of 
these are household remedies. 

POISONING BY MUSHROOMS 

Teaspoonful of mustard to a cup of hot water; 
drink at once. Large dose of castor oil. Empty 
the stomach as quickly as possible by moving the 
bowels at once. 

CAMPHOR, IF TAKEN BY CHILD 

Make him vomit by giving mustard and water. 
Give brandy or whiskey freely. 

CROUP 

Teaspoonful of wine of ipecac. Immerse in warm 
bath ten minutes. Apply hot poultices to the 
throat. Sometimes an anxious mother can be re- 
lieved of her anxiety by wringing a towel out of 
the coldest water available and wrapping it around 
the throat. 

NOSE BLEEDING 

Raise both arms above the head. Grasp the nose 
firmly between the thumb and forefinger; inject a 
quantity of ice-water to which common salt has 
been added. Saturate a towel with ice-water and 
lay across forehead. 

HEAT STROKE 

Remove patient at once to a cool room, lay 
him down near an open window and strip off the 






AND HOW TO PROTECT IT. 269 

clothes. Pour a stream of water over the body. 
Hold the pitcher five feet above the body, let it 
strike the head first, then the chest, then the arms 
and legs. Brandy and milk and aromatic spirits of 
ammonia should be given freely, if patient can 
drink; if not, inject into rectum. 

COAL GAS 

Artificial respiration at once. Cold water poured 
over the surface of the body at once. Summon a 
physician while this is being done. 

SWALLOWING OF FOREIGN SUBSTANCE SUCH AS 
UNCHEWED MEAT, STONE, ETC. 

Violent blow on the back. If this fails, stand 
patient on the head and strike with open hand be- 
tween the shoulders, moving him rapidly from side 
to side. 



270 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XLVIII 

Dancing and its Relation to Pneumonia 
and Consumption 

In the few brief words I shall say upon this sub- 
ject I am aware that I shall at once meet with op- 
position from that vast number of young men and 
women who engage in this pastime. By many of 
you I shall be termed a crank and by others a fa- 
natic, but I assure you that it is farthest from my 
mind to deprive you of any pleasure which you may 
derive from dancing. It is plainly my duty, how- 
ever, to warn you of the dangers and after that — 
well, he who dances must pay the fiddler, or his 
parents the undertaker. Stop a moment and ask 
yourself if you have not too often heard this ex- 
pression, "She attended a dance, contracted a cold, 
had a chill, took pneumonia, and lived only a few 
days." Dancing, as it is conducted today in both 
city and country, predisposes to acute cold and an 
inflammation of the throat and bronchial tubes. 
The pneumococcus, active and plenty at the season 
of the year when dancing and balls are at their 
height, seeks these inflamed tissues and begins at 
once to set up an inflammation, causing chills, 
fever, congestion, which rapidly travels to the lung 
tissue itself, and consequently a train of symptoms 
which you have all seen follows these attacks. 






AND HOW TO PROTECT IT. 271 

Grave danger lurks in the overheating of the 
blood from the violent and exciting exercise of 
dancing, which is followed in many instances with 
diseases which often terminate fatally. 

The great charity and society balls in New York, 
Boston and Chicago reap their annual crops of 
death every year. Hundreds of young men and 
women annually fall prey to pneumonia and early 
tuberculosis, traceable directly to one of these func- 
tions. The ball-room may have its dangers in a 
social way, overestimated, I think, by the church 
and clergy, but vital statistics bear out the fact, 
coupled with the history of the case, that hundreds 
of lives are annually sacrificed upon the altar of 
Terpsichore. 



VJ2 THE WORKING PEOPLE: THEIR HEALTH 



CHAPTER XLIX 
What to Eat and How to Eat it 

It has been well said that no army advances ex- 
cept upon its belly, and it might be added with 
equal pungency that civilization crawls upward on 
its stomach. The napkin and the fork differentiate 
civilized man from the savage quite as certainly as 
the Bible and the spelling-book. To eat with one's 
fingers is not necessarily a sign of irreligion, and 
the table manners of some quite devout Europeans 
are said to be abominable. Yet there is a science 
about so simple a thing as eating and drinking, and 
until we Americans have mastered that science we 
shall continue to be known as a nation of dyspeptics, 
and shall suffer in our stomachs and our pocket- 
books until as a people we learn to practice more 
self-denial and less gluttony; more common sense 
and less foolishness. More deaths are caused in 
the United States annually by indigestion than by 
strong drink. 

In a work of this kind, with its diversity of sub- 
jects, I can allude but briefly to a few salient and 
stubborn facts that confront every physician, when 
he attempts to minister to a stomach diseased. In 
the first place the best way to defy dyspepsia is to 
dodge it in advance, and in order to dodge it in 
advance, you must begin at the very picket-line of 



AND HOW TO PROTECT IT. 273 

mastication, beginning with the teeth themselves. 
Many otherwise very clean persons act as though 
they had no such things in their heads as teeth, and 
yet upon their care depends very largely the state 
of their bodily health. They should be brushed 
thoroughly on arising, after every meal and before 
retiring, with this solution: Hydrogen peroxide 
two teaspoonfuls to one-half cup water. 

Don't be afraid to chew your food. More people 
have died from not chewing their food enough than 
have ever died from chewing it too much. Masti- 
cate every particle of food you put into your mouth 
thoroughly. After you have done so you will swal- 
low your food naturally; you will not have to gulp 
it down. Do not hurry your meals. It is not the 
amount you eat that sustains life ; it is the way in 
which you eat it. A little eaten properly will 
benefit you and keep you going until the next meal 
is due; where a great mass of half-masticated food 
thrown into your stomach in a hurry will clog that 
organ, render you lazy and uncomfortable, and pave 
the way for all the horrors of indigestion and per- 
haps death itself. An attack of apoplexy has not 
infrequently followed a hearty meal, hastily par- 
taken of. Avoid haste, worry and anger, when you 
eat, as you would a deadly reptile. 

Stop eating when you feel that you have eaten 
enough. Do not look around the table to see if 
there isn't something more you could spur your 
jaded appetite into appropriating, and do not allow 
yourself to be enticed into eating more than you 
want, no matter how attractive it looks nor how 
eloquently it is pressed upon you. It is safer for 



274 TH E WORKING PEOPLE: THEIR HEALTH 

you in the garbage barrel than in an overloaded 
stomach. 

Eat as a rule what appeals to you. If you like 
flesh, eat it; if you like vegetables, eat them; if 
fruit appeals to you, eat fruit; if bread, bread; if 
pastry, pastry. If you like them all eat them all, 
but in every case with moderation and temperance. 
Many good temperance men drink tea and coffee to 
excess and gorge themselves like gluttons, and yet 
they affect to look down upon the poor drunkard. 
There is eminent authority for putting the glutton- 
ous and the wine-bibber in the same class. I shall 
not prescribe an exclusive dish for any reader of 
these pages. If your stomach is "out of kilter," as 
the phrase goes, eat as little as possible for a few 
days — it is no bad thing to fast a little occasionally, 
for the stomach's sake as well as the church's sake, 
and then try the simple foods which I have outlined 
below and which I have selected for their general 
excellence and palatability. 

If possible never eat a cold meal, and if your 
work is such that you cannot readily obtain warm 
food, be sure to drink something warm. The 
stomach is chilled by cold food, just as it is warmed 
by warm food, and the temperature is lowered in 
it by cold victuals, as the temperature is lowered 
in your boiler when you let in cold water. No good 
engineer will allow the steam to get down and 
attempt to keep the machinery running by admit- 
ting cold water to his boiler. No wise workman 
will impair his efficiency by eating cold meals. The 
list of foods I would recommend to those suffering 
from incipient dyspepsia follows: 



AND HOW TO PROTECT IT. 275 



GENERAL RULES 



Always take your meals at regular intervals. 

Avoid drinking with the meals. 

Those suffering from dyspepsia should take: 

SOUPS 

Clear soup of beef and mutton ; a little tapioca 
may be boiled with these. Tomato soup, thin, may 
also be taken. 

FISH 

Perch, trout, bass, smelt, whiting, wheatfish, shad. 

MEATS 

Roast beef rare, boiled beef, mutton, chicken, 
tripe, venison, lamb chops, roast partridge, plover. 

EGGS 

Dropped on toast or stale bread, poached eggs, or 
soft boiled. 

BREAD 

Never eat fresh bread unless thoroughly toasted; 
rye bread, gluten, graham, cream crackers, cracked 
wheat, rice, sago, tapioca, macaroni with bread 
crumbs, cornmeal, hominy, wheaten grits, graham 
grits, rolled oats, rice cakes, bound rice. 

VEGETABLES 

Water-cress, spinach, lettuce, sweet corn, green 
peas, asparagus, baked tomatoes, and potatoes in 
small quantities. 



276 THE WORKING PEOPLE: THEIR HEALTH 
DESSERT 

Fruit of all kinds, except bananas. Rice pudding, 
sponge-cake, orange charlotte, gelatine, cream, blanc 
mange, baked apples, and all ripe fruits if fresh; 
no rich sauces. 

DRINKS 

Hot water before meals. Vichy, weak tea, pep- 
tonized cocoa, milk, buttermilk, malted milk, black 
coffee when it seems to agree with the stomach, 
mineral water, Congress water, Apollinaris, Poland 
and Highland Spring. 

STIMULANTS 

Brandy and water, hock, light claret. 

MUST AVOID 

Sweet, effervescent wines, strong spiritous 
liquors, rich stews and chowders, all fried foods, 
hot or fresh bread, griddle cakes, doughnuts, pork, 
liver, kidney, hashes. Pickled and corned meats, 
turkey, goose, duck, sausage, salt mackerel, blue- 
fish, sardines, lobster, cabbage, cauliflower, cucum- 
bers, egg-plant, carrots, squash, sweet potatoes, all 
pastry, pies, made dishes, nuts, dried and canned 
fruits, candies, cheese, strong tea, ice-water. 



AND HOW TO PROTECT IT. 277 



CHAPTER L 
Hydrotherapy and its Relation to Health 

HOT AND COLD COMPRESSES 

Water is not only the most ancient remedy in 
the prevention of disease, but it is also one of the 
first remedies used in the cure of diseased condi- 
tions, and properly used is today one of the most 
potent remedies both for prevention and cure. Its 
great potency has been brought forward of late by 
the study of the Assyrian and Egyptian records. 
One reason for this lies in the fact that water is 
usually found ready at hand and approaches more 
nearly a panacea than any other known remedy. 
No other agent is capable of producing so great a 
variety of physiological effects, no other is so uni- 
versally present, and hence no remedy is so readily 
adaptable for meeting the various indications aris- 
ing from accident and disease. 

The ancient Persians, Greeks, Hebrews and Hin- 
doos all employed water in the treatment of dis- 
ease, and even at the present time it is employed 
by them. Latter-day researches have demonstrated 
its worth; today, we are again harking back to 
primitive days, and like the use of fresh air we 
must recognize its potency when applied in an in- 
telligent manner. 



278 THE WORKING PEOPLE: THEIR HEALTH 

In cases of emergencies, for example some one 
has fainted, give a glass of cold water. Typhoid 
fever, plenty of cold water. Inflammation of the 
joints, cold water pack, and a multitude of other 
uses which I shall enumerate in addition to the 
bath, in this chapter and in other portions of this 
book. 

COLD WATER BATH 

Better known as the plunge bath. This bath is 
the most useful of all forms of baths. The bath- 
tub filled with cold water, the person gets into 
it quickly, simply lies down, immersing the whole 
body in the water and then arising quickly; using 
a large, coarse bath towel, rub the surface of the 
body rapidly until a red glow is produced all over 
the body ; then dress quickly. This bath is indicated 
where there is nervousness, where there is a gen- 
eral run-down condition of the health, in dyspepsia, 
and in anaemia or depraved blood conditions. 

SUN BATH 

Sunlight is one of the most powerful of all 
hygienic and curative agents. It is death to nearly 
all microbes, very few of which are unable to resist 
the action of the direct rays of the sun after more 
than a few minutes. Sunlight is, therefore, one of 
the most important of all disinfecting and sterilizing 
agents. The value of sunlight is shown when in 
caves and mines and other places where light is 
excluded from plants, they will not grow, but die 



AND HOW TO PROTECT IT. 279 

quickly. Animals also deprived of sunlight soon 
sicken and die. 

It has been noticed in some hospitals, according 
to records, that a larger per cent, of recoveries occur 
on the sunny side of the ward than on the shady 
side. 

To have a sun bath effective the room in which 
this bath is taken should face the south. The pa- 
tient should lie on a cot before the window or win- 
dows and the head should be protected. The dura- 
tion of the bath should not be over ten minutes with 
the whole body exposed. 

The effect of this bath: The surface circulation 
is greatly increased, the heart's action is increased 
and the action of all the vital organs is promoted. 
Sun baths are useful in cases of malnutrition, 
anaemia, in inactivity of the skin, chronic dyspepsia, 
most cases of nervous indigestion, rheumatism and 
obesity, but never should be taken if the person has 
once had sunstroke. 

Ancients made great use of the sun bath in the 
treatment of the sick. According to Plutarch, Diog- 
enes, the renowned Athenian cynic, was accustomed 
in his old age to lie in the sunshine for the purpose 
of recruiting his energies. Pliny states that this 
was practiced among the Greeks, as also the 
Romans. 

THE COLD SITZ BATH 

This bath causes very pronounced effects upon 
the pelvic circulation. It can be used in hemor- 
rhage of the bladder, utris, rectum, hemorrhoids, 
and in some of the chronic inflammations of the 



280 THE WORKING PEOPLE: THEIR HEALTH 

pelvic organs. A hot foot-bath should be admin- 
istered at the same time. This bath is taken by 
sitting either in a bath-tub half rilled with water or 
in a special small tub, large enough for this purpose. 
The temperature of this bath should be 85 to 90 to 
begin with and the hot foot-bath should be 104 to 
no. In a very hot sitz bath the temperature should 
be 106 to 120, taking from two to eight minutes. It 
is well to begin with a temperature of 102 and add 
hot water until the maximum temperature is reached. 
Hot foot-baths taken at the same time should be 
108 to 118. The use of this bath is of great service 
in restoring the menstrual function when held back 
as the result of a cold or chill or in other cases. 
It is also useful in sciatica, lumbago, abdominal neu- 
ralgia and, in fact, in any pains in the region of 
the hips. 

HOT FOMENTATIONS OR HOT APPLICATIONS 

In pleurisy and acute bronchitis they are of in- 
estimable value. In the early stage hot applications 
should be employed only for short periods and the 
cold compress or ice-bag employed in the intervals, 
changing every twenty minutes for the fomentation. 
This ofttimes will break up an early cold and bron- 
chitis. It also affords relief in rheumatic pains in 
the muscles and joints. Very hot applications made 
to the upper part or back of the head, also to the 
top of the head, will often relieve congestion. The 
temperature should be 130 to 138. This may be 
used for indigestion, colic, constipation, torpid liver. 
It is also useful in many other ailments, such as 



AND HOW TO PROTECT IT. 281 

nervousness, muscular contractions, alcoholism, 
lead poisoning and heat stroke. 

These fomentations may be applied in all condi- 
tions where pain is present. It is very effective for 
the relief of pain from strains or sprains of joints 
and muscles ; for the relief of colic pains, pain from 
gall-stones. For disease of the eye-ball, very hot 
applications to the eye. Hot fomentation may be 
applied to the whole head for relief of headache, for 
toothache, migraine and earache. Care must be 
taken to confine the application to the face. Hot 
applications may be applied to the throat, in croup 
and in tonsilitis, in all forms of gastric pains and 
pain in the bowels. Hot applications are exceed- 
ingly serviceable in cases of swollen internal hem- 
orrhoids, or prolapsed rectum, with large internal 
hemorrhoids. Water should be applied as hot as 
can possibly be borne, by means of a soft cheese- 
cloth or sponge. Application should be continued 
for fifteen or twenty minutes. 

Intercostal, that is, neuralgia between the ribs, 
sciatica, and other pains of similar character are 
generally made to vanish as if by magic under the 
influence of hot fomentations. In neuralgia, in 
acute articular rheumatism in which the application 
of cold as a finishing measure may cause the return 
of pain, parts may be allowed to cool gradually, 
leaving the last application in place for fifteen or 
twenty minutes, or until it has become nearly the 
temperature of the skin. It should then be removed 
and the part dried, gently rubbed, and then covered 
with a warm, dry, soft flannel. 

19 



282 THE WORKING PEOPLE : THEIR HEALTH 

In cases of hemorrhage from the lungs (while 
waiting for the physician), very hot fomentations 
may be applied to the upper part of the spine and 
the back of the neck, in connection with cold applied 
to the chest. Applications should be very short, 
three to six minutes; should be repeated every fif- 
teen minutes. 

For indigestion, colic, suppression of urine, con- 
stipation accompanied by abdominal pain and ten- 
derness, torpid liver, very hot fomentations are of 
great value and are often used with best results. 

HOT WATER BAG 

No household should be without it. It can be 
used for a variety of aches and pains. Dr. Chap- 
man said, "I have for twenty years made use of the 
spinal hot water bag I had constructed for the pur- 
pose." The application of the hot water bag is 
desirable for the relief of indigestion and pain, in- 
cluding distention of the bowels, and here I want 
to add that distention of the bowels caused by gas, 
causing ofttimes severe pain, can be removed by 
wringing out a cloth in one quart of hot water to 
which have been added two teaspoonfuls of spirits 
of turpentine. Use a thick piece of flannel applied 
to the bowels as hot as can be borne; then cover 
with hot water bag. 

THE WET GIRDLE 

is the same as a pack except that it covers a small 
area. The region to which it is applied is bounded 
by the nipple line above and the top of the hips 



AND HOW TO PROTECT IT. 283 

below. This measure has been exceedingly popular 
in Germany for the last 150 years. It simply con- 
sists of wringing out a cloth in water as hot as 
can to borne, wide enough to cover the points in- 
dicated above. This may be covered with an oil- 
silk over which has been placed a piece of cheese- 
cloth. This moist girdle is excellent in chronic 
dyspepsia, constipation, intestinal catarrh, conges- 
tion of the liver; it is also a panacea in cases of 
chronic backache; also in heaviness across the ab- 
domen, or when the seat of discomfort is located 
at the hips. 

THE HEAD PACK 

Ordinary cloth compress, wet in cold water and 
applied to the head after the scalp has been thor- 
oughly wet. A cap made of rubber, similar to the 
one used by ladies in bathing, is placed over these 
compresses and the retention of heat soon warms 
and produces comfort. The use of this stimulating 
head-cap may be called for in chronic headache or 
chronic neuralgia or rheumatic effects of the head, 
also excellent in chronic nasal catarrh. 



HOT ENEMA OR HOT INJECTION 

This is one of the most useful means of combat- 
ing inflammation of the pelvis. Administered three 
or four times a day at a temperature of no to 115, 
it will be found of great service. In the onset of 
fevers, such as la grippe and cold, it is a most ex- 
cellent remedy. A hot enema or injection at 102 



284 THE WORKING PEOPLE: THEIR HEALTH 

to 1 10 is useful in bilious colic, so called. It is also 
useful in treatment of colic and infantile diarrhoea. 

WATER DRINKING 

Water drinking is a therapeutic measure which 
is of very ancient origin. It was described by 
Hypocrates as a remedy in fevers. Cold water 
drinking was used by Hahn in fevers, the first half 
of the eighteenth century. It has also been used 
by the Italians, French and Persians. 

Schultz has shown that the copious drinking of 
water increases the proportion of water in the blood 
nearly six per cent, by thinning the blood. Large 
quantities of water drinking increase the activity of 
the skin and bowels. 

In obesity, or too much fat, drinking large 
amounts of water assists in carrying off the broken 
down material. To forbid the drinking of water in 
obesity or over-fleshiness is a great error. In all 
conditions where fevers are present give plenty of 
water. Copious drinking of water is one of the 
most effective means of getting rid of a common 
cold by carrying off poisons. 

One or two glasses of cold water taken a half 
hour before breakfast, in many instances works 
wonders in activity of the bowels and constipation. 
For chronic bilious attacks recurring every two or 
three weeks, drink plenty of water. 

HOT WATER DRINKING 

The fact that hot water has proved serviceable in 
some cases has led to its excessive use by many 



AND HOW TO PROTECT IT. 285 

persons. The general effect of warm water drink- 
ing is to break down the digestive system, while 
cold water acts as a tonic. Avoiding the free use 
of cold water at meals is an important hygienic 
rule. Cold water interferes with the digestion of 
starch. 



286 THE WORKING PEOPLE : THEIR HEALTH 



CHAPTER LI 

The Press and its Influence in the Fight 
Against Consumption 

The war that is being waged at the present time 
against consumption (the fighters being re-inforced 
by the public press at every turn) is a war on pov- 
erty and crime, the far-reaching influence of which 
can hardly be estimated. Just how far we could 
have advanced without the assistance of the press 
is a question hard to answer. How great that in- 
fluence is can better be understood when we are 
told that during certain weeks of the present year 
the press was printing a half mile of reading mat- 
ter, all instructive, all new, all bearing on this great 
fight. The proceedings of our great International 
Congress on Tuberculosis were sent around the 
world in the columns of the newspapers. 

During the last seven months the press has 
brought to the attention of the laity, and in many 
cases to the physician himself, facts of such in- 
estimable value that their value in dollars and cents 
can never be calculated. Let me illustrate one 
point: The manufacturers and merchants in my 
health district entered into an agreement to care 
for their cases of incipient tuberculosis. The Asso- 
ciated Press sent this intelligence broadcast 
through the United States. Naturally it reached 



AND HOW TO PROTECT IT. 287 

the Old World as well. Inquiries as a result have 
come to me from every state in the Union, as well 
as abroad, as to the agreement. As a result of this 
movement, which, at the present time, is sending 
those afflicted to Rutland and similar institutions 
and returning them cured, the matter has been 
taken up in different states, and at this writing, as 
far as I am able to learn, more than two hundred 
manufacturing establishments have entered into 
this fight, and if the same ratio of cases is cared 
for in other places that is in this district, one hun- 
dred people each week are receiving aid at $4 each. 
This means $4 a week, $16 each month, or $20,000 
a year, and the movement only started in Novem- 
ber, 1908. And the press has spread, without money 
and without price, the intelligence of this great phil- 
anthropic and Christian movement. 

In December of last year, when the exhibit of 
the International Congress was moved from Wash- 
ington to New York city, the enthusiasm was kept 
at fever heat by the public press. Column after 
column of the great New York journals was given 
up to publishing facts about the exhibit and the 
reason why people should attend it, and was mainly 
responsible for a large share of an attendance of a 
million and a half of people, who had the oppor- 
tunity of studying what science is doing for con- 
sumption. In the city of Philadelphia it shaped 
public opinion and assisted the Philadelphia Asso- 
ciates to accomplish these things, which they could 
never have done without its assistance. 

It has brought to the attention of the public the 
constituents of many patent nostrums, showing 



288 THE WORKING PEOPLE: THEIR HEALTH 

their effect on the human system. It has heralded 
broadcast the need of pure food laws, and it has 
apprised people of the need of more legislative 
measures for the protection of health. Its editorial 
columns have printed that address delivered by- 
Prof. Victor C. Vaughn of the University of Mich- 
igan, a part of which reads as follows : 

"Please do not understand from what I have said 
that I am a pessimist, for such I surely am not, but 
we must see and appreciate our weakness, if we are 
to relieve ourselves of it and grow stronger. This 
crusade against tuberculosis is the greatest work 
that man has so far attempted. We of this genera- 
tion are starting it, and those who come after us 
will, we hope, complete it. I certainly believe that 
the time will come when tuberculosis will no longer 
curse our race. How soon this time will come it 
would be folly to predict, for that depends on the 
intelligence and earnestness of the effort that is put 
into the work. The eradication of this disease is 
by no means solely the medical man's problem; it 
demands the combined intelligence and labor of all 
men who are interested in the welfare of the race, 
and the individual- who regards it with indifference 
should find no place in our legislative halls, either 
national or state. To take the life of a fellow-man 
willfully or maliciously is murder, the greatest of 
all crimes; to do so through ignorance or careless- 
ness is manslaughter. In effect it is the same as 
murder, although in guilt it may be less heinous. 
The great majority of deaths from tuberculosis are 
due to manslaughter, and this fact should be recog- 
nized. The man who carelessly or ignorantly ex- 



AND HOW TO PROTECT IT. 289 

pectorates infected sputum, which, after drying, 
may be inhaled and may infect another, is guilty of 
manslaughter. The same is true of the dairyman 
who sells infected milk, or of the owner who lets 
an infected house. It is essential that we recognize 
these truths before we can be successful in our 
crusade against tuberculosis. The man who would 
put arsenic in milk or drinking-water would be 
regarded by the law as either a criminal or a luna- 
tic, and in either case he would be so dealt with 
that he could not repeat the offense. The man who 
sells milk or other food infected with the tubercle 
bacillus or other disease-producing germs, is dis- 
tributing a more deadly poison than arsenic, and he 
should be forbidden the continuance of such a prac- 
tice. We need wise laws in order to restrict and 
eradicate tuberculosis, and their adoption and en- 
forcement are sure to come as soon as the mass of 
the people see the matter in the true light. 

"Our state governments should place tuberculosis 
en the list of diseases dangerous to the public 
health, require that all cases be reported, and the 
local health authorities should see that the disease 
is not disseminated. I do not think that any med- 
ical man holds that the homes of the tuberculous 
should be placarded or quarantined, but the tuber- 
culous individual should be minutely and carefully 
instructed as to the care that he must take with his 
excretions in order that he may not transmit the 
disease to others. " 

The lessons which are being taught by the public 
press have their influence in two ways : first, they 
furnish to a large army of readers subject matter in 



290 THE WORKING PEOPLE: THEIR HEALTH 

such a form that they will read it and, second, they 
place it at the disposal of many too poor to be able 
to purchase it otherwise. 

I believe now, as I have in the past, that the press 
in this fight will illustrate the old adage, "the pen 
is mightier than the sword," and that the influence 
wielded by the public press of today will be of a 
material benefit not alone to those of us who live 
today, but to countless millions yet unborn. 



AND HOW TO PROTECT IT. 291 



CHAPTER LII 
Conclusions 

The conservation of the health and energy of our 
eighty millions of American citizens must very soon 
become a national consideration. Otherwise, the 
streams of life polluted, all along their course, by 
work, worry, want and unnatural stimulation, will 
soon allow our longevity to sink below high-water 
mark, and our American reservoir of human energy 
to become sadly depleted. 

If the working people of this country have a right 
to ask for protection against foreign invasion, they 
have a just right to ask for protection against dis- 
ease. 

A saner system of eating and drinking in our 
American cities must be observed before our lon- 
gevity will be materially increased. 

Excesses in overeating cause more deaths than 
excessive drinking. 

Consumption is a curable and preventable dis- 
ease. 

If we are to stamp out tuberculosis we must care 
for the advanced cases and provide early treatment 
for the incipient cases. 

The present war on consumption is also a war on 
poverty and crime. 



292 THE WORKING PEOPLE: THEIR HEALTH 

The present curriculum in our public schools is 
overcrowded, and the lack of physical training is 
tending towards physical degeneracy. 

Houses built for working people should be con- 
structed with more care, and laws relating to tene- 
ment house inspection should be enforced in every 
State. 

Laws prohibiting the manufacture of cigarettes 
should be placed upon the statute book of every 
State in the Union, and a National Board of Health 
should be established by our next Congress. 

The unnecessary loss of life through avoidable 
sickness in one year is appalling. The world would 
stand aghast if the same numbers of lives were lost 
in war in a decade. 

The ventilating systems in our public schools 
are a constant menace to the health of both pupil 
and teacher, and alcohol and syphilis cause about 
30 per cent, of all tubercular deaths. 

The vicious habit of sending moderately advanced 
cases of tuberculosis away from home should be 
abolished. 

The present working day is too long and leads 
to fatigue, which creates a desire for unnatural 
stimulation and results in consequent intemperance. 

The present high mortality from tuberculosis 
among housewives is due in over 75 per cent, of 
cases to over-fatigue and frequent child bearing, 
coupled with insufficient care after the birth of the 
child. Finally, if more mothers would nurse their 
children the present enormous infant mortality 
would be materially reduced. 



AND HOW TO PROTECT IT. 293 



CHAPTER LIII 

Acknowledgments 

I am indebted to Prof. Irving Fisher for his per- 
mission to use the valuable statistics quoted in the 
chapter, "The Working Day," taken from his report 
on National Vitality; to the Massachusetts State 
Board of Health for the use of their pamphlet, "Pre- 
vention and Spread of Tuberculosis ;" to the Boston 
Association for the Prevention of Tuberculosis, for 
permission to reprint their pamphlet, "Protection of 
Health;" to the Technical World Magazine, fol- 
ks article upon "Drinking-cups and their Relation 
to Disease ;" to the Prudential Life Insurance Com- 
pany for valuable statistics in the chapter, "Impor- 
tance of the Early Recognition of Tuberculosis;" 
to all the daily press, for its publicity work in 
connection with the extension of the Worcester 
Manufacturers and Merchants' Agreement for the 
care of tubercular employees; to Outdoor Life, for 
the chapter on "Care of One's Self After Returning 
from a Sanatorium, or After a Preliminary Rest at 
Home;" and to friends in the medical profession 
for many wise and useful suggestions. 



"3 23 191 



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